Author/Editor     Kozar, Nejc; Ferant, Žan; Dolinšek, Jernej; Šikić Pogačar, Maja; Mičetić-Turk, Dušanka
Title     Bone mineral density correlates with t-TG levels in pediatric patients with celiac disease
Type     članek
Vol. and No.     Letnik 8, št. 1
Publication year     2014
Volume     str. 19-26
ISSN     1840-2291 - HealthMED : Journal of Society for development in new net environment in B&H
Language     eng
Abstract     Background and Aims: Chronic inflammation and malabsorption in celiac disease (CD) can cause bone metabolism alterations and bone mineral loss. Low bone mineral density (BMD) is a risk factor for osteoporosis and bone fracture, not only in childhood and adolescence, but also later in adulthood. The aim of the present study was to determine the extent, to which anti-tissue transglutaminase (t-TG) antibody levels correlate to bone mineral density (BMD) in children and adolescents with CD. Methods: The study included 41 pediatric patients with CD (23 girls, 18 boys), between 10 and18 years of age, and control group of 37 healthy subjects (19 boys, 18 girls). All patients declared to be on a strict gluten free diet (GFD) for the period of at least 6 months prior to the study. Anti-tissue transglutaminase (t-TG) level was measured in all the patients. Lumbar and left hip BMD were measured using dual-energy X-ray absorptiometry (Hologic Explorer QDR). Results are expressed as Z scores for a particular chronological age. Results: Bone mineral density in children and adolescents with CD, who are consuming a strict GFD, was not significantly lower according to the local reference values (lumbar Z = -0.2 and left hip Z = -0.4). When compared to the control group, their BMD showed no significant difference (lumbar Z = -0.3 and left hip Z = -0.8). Even though all the patients declared to be on a strict gluten free diet, only 58 % of them had negative values of t-TG. Interestingly, we found a significant negative correlation between BMD and t-TG levels within the serologically negative CD patients, where higher levels of t-TG were associated with lower BMD (R = -0.5, p = 0.032). Conclusion: A strict gluten-free diet is of great importance in patients with CD. It reduces the risk of long-term complications such as osteoporosis in this group of patients. Our results indicate that bone mineral density even in patients, who are consuming a strict GFD and are considered serologically negative can be affected according to the levels of t-TG which relates to the strictness of the diet. It is therefore strongly recommended that all CD patients comply with gluten free diet as strictly as possible.
Keywords     mineralna kostna gostota
celiakija
brezglutenska dieta
tkivna transglutaminaza
otrok
mladostnik