Men's Osteoporosis Support GroupMetabolic bone disease in children with celiac disease J Pediatr Gastroenterol Nutr. 2009 Jul 28. [Epub ahead of print]. Prevalence of Metabolic Bone Disease in Children With Celiac Disease Is Independent of Symptoms at Diagnosis. Turner J, Pellerin G, Mager D. PMID: 19644400. The authors point out that when children with celiac disease are exposed to gluten they may have malabsorption of nutrients which then leads to bone problems, including osteoporosis. This study evaluated medical records of 74 children with celiac disease from April 1989 to September 2007 to verify the importance of symptoms at diagnosis regarding the degree of bone health problems. To determine bone health the Z-score was used, which compares an individual's bone mineral density (BMD) to age- and gender-matched controls. In adults, the T-score is used to compare older individual's BMD to younger gender-matched controls, but the T-score would not be applicable in the case of children. The findings showed, "Lumbar BMD z scores more than or equal to -1 were observed in 58 cases (65%), z scores below -1 but above -2 were observed in 14 cases (19%) and z scores less than or equal to -2 were observed in 12 cases (16%). There was no significant difference in mean lumbar BMD z scores between symptomatic and asymptomatic children (P = 0.34)." There was no correlation between symptoms at diagnosis and the degree of BMD problems. The authors concluded, "Delayed diagnosis of children with celiac disease may increase the risk of adult osteoporosis. Appropriate screening of children at risk of celiac disease for the purpose of early diagnosis, as well as routine evaluation of bone mineral density in such children, are important to prevent long-term complications associated with poor bone health." Emphasis mine. Editor's comments. There is an information page regarding celiac disease (celiac sprue) on the Men's Website. In short it is a disease that presents as the inability to handle gluten in the diet which results in malabsorption of important nutrients. It can be symptomatic or asymptomatic, and difficult to diagnose. Osteoporosis is one consequence of untreated celiac disease. As the Turner study shows the BMD problems can develop in children with celiac independent of the symptoms. So young children should be tested for gluten intolerance if there is any concern about celiac disease, especially a family link to celiac. The long-term consequences can be devastating, and are completely avoidable if the person adheres to a gluten-free diet.
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