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Reduced Bone Mineral Density in Children with Screening-detected Celiac Disease

Björck, Sara LU ; Brundin, Charlotte LU ; Karlsson, Magnus LU and Agardh, Daniel LU (2017) In Journal of Pediatric Gastroenterology and Nutrition 65(5). p.526-532
Abstract

Objectives: The aim of the study was to assess whether bone mass and metabolism are impaired in genetically at-risk children with screening-detected celiac disease. Methods: Included were 71 children with screening-detected celiac disease diagnosed at 10.0 ± 0.7 (mean ± standard deviation) years and 142 matched controls and 30 children with screening-detected celiac disease diagnosed at 3.3 ± 0.4 years of age presently on a gluten-free diet for 6.9 ± 1.1 years and 60 matched controls. All participants were assessed for bone mineral density (BMD) of total body and spine by dual X-ray absorptiometry, serum 25(OH) vitamin D3, parathyroid hormone (PTH), interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, IL-15,... (More)

Objectives: The aim of the study was to assess whether bone mass and metabolism are impaired in genetically at-risk children with screening-detected celiac disease. Methods: Included were 71 children with screening-detected celiac disease diagnosed at 10.0 ± 0.7 (mean ± standard deviation) years and 142 matched controls and 30 children with screening-detected celiac disease diagnosed at 3.3 ± 0.4 years of age presently on a gluten-free diet for 6.9 ± 1.1 years and 60 matched controls. All participants were assessed for bone mineral density (BMD) of total body and spine by dual X-ray absorptiometry, serum 25(OH) vitamin D3, parathyroid hormone (PTH), interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, IL-15, interferon gamma, and tumor necrosis factor alpha. Results: At diagnosis, screening-detected celiac disease children as compared to controls had a mean-0.03 g/cm 2 reduced BMD of both total body and spine (P = 0.009 and P = 0.005, respectively), a mean-11.4 nmol/L lower level of 25(OH) vitamin D3 (P < 0.001), and a mean +1.0 pmol/L higher PTH level (P < 0.001). Systemic levels of the cytokines IL-1β, IL-6, IL-8, IL-10, IL-12p70, IL-13, and tumor necrosis factor alpha were all increased in screening-detected celiac disease as compared to controls (P < 0.001). No difference in BMD, 25(OH) vitamin D3, PTH, and cytokine levels were detected in children on a gluten-free diet compared with controls. Conclusions: Children with screening-detected celiac disease have reduced BMD, lower levels of vitamin D3, higher levels of PTH, and signs of systemic inflammation compared with controls. These differences were not found in celiac disease children on a gluten-free diet, indicating that children with screening-detected celiac disease benefit from an early diagnosis and treatment.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
autoantibody, bone mass, HLA, inflammation, tissue transglutaminase
in
Journal of Pediatric Gastroenterology and Nutrition
volume
65
issue
5
pages
7 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:85015613632
  • wos:000417650600020
ISSN
0277-2116
DOI
10.1097/MPG.0000000000001568
language
English
LU publication?
yes
id
1747f0c0-0eff-4854-a85a-5c5beeb41cd9
date added to LUP
2017-11-22 12:22:31
date last changed
2018-01-16 13:26:16
@article{1747f0c0-0eff-4854-a85a-5c5beeb41cd9,
  abstract     = {<p>Objectives: The aim of the study was to assess whether bone mass and metabolism are impaired in genetically at-risk children with screening-detected celiac disease. Methods: Included were 71 children with screening-detected celiac disease diagnosed at 10.0 ± 0.7 (mean ± standard deviation) years and 142 matched controls and 30 children with screening-detected celiac disease diagnosed at 3.3 ± 0.4 years of age presently on a gluten-free diet for 6.9 ± 1.1 years and 60 matched controls. All participants were assessed for bone mineral density (BMD) of total body and spine by dual X-ray absorptiometry, serum 25(OH) vitamin D3, parathyroid hormone (PTH), interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, IL-15, interferon gamma, and tumor necrosis factor alpha. Results: At diagnosis, screening-detected celiac disease children as compared to controls had a mean-0.03 g/cm 2 reduced BMD of both total body and spine (P = 0.009 and P = 0.005, respectively), a mean-11.4 nmol/L lower level of 25(OH) vitamin D3 (P &lt; 0.001), and a mean +1.0 pmol/L higher PTH level (P &lt; 0.001). Systemic levels of the cytokines IL-1β, IL-6, IL-8, IL-10, IL-12p70, IL-13, and tumor necrosis factor alpha were all increased in screening-detected celiac disease as compared to controls (P &lt; 0.001). No difference in BMD, 25(OH) vitamin D3, PTH, and cytokine levels were detected in children on a gluten-free diet compared with controls. Conclusions: Children with screening-detected celiac disease have reduced BMD, lower levels of vitamin D3, higher levels of PTH, and signs of systemic inflammation compared with controls. These differences were not found in celiac disease children on a gluten-free diet, indicating that children with screening-detected celiac disease benefit from an early diagnosis and treatment.</p>},
  author       = {Björck, Sara and Brundin, Charlotte and Karlsson, Magnus and Agardh, Daniel},
  issn         = {0277-2116},
  keyword      = {autoantibody,bone mass,HLA,inflammation,tissue transglutaminase},
  language     = {eng},
  month        = {11},
  number       = {5},
  pages        = {526--532},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Journal of Pediatric Gastroenterology and Nutrition},
  title        = {Reduced Bone Mineral Density in Children with Screening-detected Celiac Disease},
  url          = {http://dx.doi.org/10.1097/MPG.0000000000001568},
  volume       = {65},
  year         = {2017},
}