公開日:2022/06/16 / 最終更新日:2022/06/16
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Children with celiac disease are at increased risk of osteoporosis and metabolic bone disease. This study was designed to examine the biochemical and densitometric determinants of bone metabolism in children with celiac disease compared with those in normal children and those of children with gastrointestinal (GI) cancer. Bone metabolism was evaluated in 16 children with celiac disease (mean [+/- SD] age, 12.8 +/- 2.8 years; mean [+/- SD] height, 126.1 +/- 12.4 cm) and 16 age-matched controls. Celiac disease was diagnosed on the basis of a prolonged (greater than 6 months) response to a gluten-free diet, a duodenal biopsy with villous atrophy, and a positive celiac-specific antibody test (anti-endomysial antibody or tissue transglutaminase IgA or IgG). Compared with normal children, children with celiac disease had lower bone mineral density (BMD) in the lumbar spine (-1.4% +/- 2.5%) and femur (-4.8% +/- 1.9%), and lower BMD Z score (weight-adjusted BMD score; -1.1 +/- 0.4). These data indicate that children with celiac disease have significantly impaired BMD compared with age-matched controls. However, children with celiac disease had significantly greater total body bone mineral content (2.2% +/- 1.7%) and BMD (1.0% +/- 0.5%) than children with GI cancer and normal children, and they had significantly greater lumbar spine BMD Z score (0.7 +/- 0.2) compared with children with GI cancer. The increases in BMD in children with celiac disease compared with age-matched controls could be explained, at least in part, by greater lean body mass, but reduced gastrointestinal motility and inflammation might have contributed. These