Abstract

We were interested in detecting the changes in bone mineral density (BMD) in prepuberal and puberal celiac children after 24 months of supplementation with 1000 mg of calcium and 400 U of vitamin D daily. 19 celiac children (16 females, and 3 males, age 6 to 15 years) with good compliance to the gluten free diet for at least two years, paired with 19 healthly children of the same age and sex were studied. Celiac patients had mean calcium intakes of 739 mg per day, that increased to 1444 mg per day after nutritional supplementation, with 84 and 74% of compliance during the first and second years of supplementation. Celiac patients did not show significant changes in stature and nutritional status during suppplementation. The whole group of celiac subjects showed a significant increase in z score of WB-BMD and FN-BMD from the start and until 24 months of supplementation, compared to the controls (WB-BMD: -0.24+/-0.40 and -0.80+/-0.59 vs 0.49+/-0.62 and 0.62+/-0.83. FN-BMD:-0.41+/-0.96 and 0.04+/-1.12 vs 0.58+/-1.29 and 0.36+/-1.15 respectively) Total group and pubertal celiac patients showed a significantly greater variation (delta z score) of hip BMD (FN-BMD 0.53+/-0.85 p <0.025 and 0.47+/-0.72 p<0.001) than controls ( -0.21+/-0.66 and -0.39+/-0.49 respectively). Despite this increase in BMD, after 24 months of supplementation celiac patients still had significantly lower values than the controls (WB -0.08+/-0.59 p<0.05, FN 0.04+/- 1.12 p <0.03). Although calcium and vitamin D supplementation for 24 months had beneficial effects on the bone mass of celiac patients in whole body (WB) and femoral. neck (FN) measurements, these did not reach the BMD of controls. (C) 2000 Elsevier Science Inc.