Çölyak hastalığı olan çocuklarda kemik mineral dansitesinin uzun süreli izlenimi
No Thumbnail Available
Files
Date
2007
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Tıp Fakültesi
Abstract
Aim To evaluate effect of long term gluten free diet on bone mineral density (BMD) in children with celiac disease. Material- Method Thirthy seven children with celiac disease, diagnosed based on European Society of Pediatric Gastroenterology and Hepatology revised criteria, were recriuted to study in Ankara University, Faculty of Medicine, Pediatric Gastroenterology Department. None of them had a chronic illness or treated with a drug which effects bone metabolism. Serum total protein, albumin, total calcium, inorganic phosphorous, alkalen phosphatase, parathormone (PTH) and BMD in lumbar 2-4 vertebra (L2-4) were evaluated at diagnosis and follow up. Bone mineral density in L 2-4 were compared with age and sex matched mean BMD in L2-4 of 143 healty children. Results Mean BMD of celiac patients (0.5073 ± 1, 14 g/cm2) was significantly lower than control group (p= 0.005) at diagnosis. Seventeen (45.9%) patients had osteopenia and 4 (10.8%) had osteoporosis with respect to aged matched z score. Mean age, height, body weight and L2-4 BMD both positively corelated to each other (p<0.001), but there were no relation between L2-4 BMD and calcium, phosphorus, alkalene phosphatase, PTH levels. Mean follow up period were 3.56 ± 2.29 years (1-8 years). Mean height, body weight, total calcium and alkalen phosphatase, BMD L2-4, aged matched z score significantly increased at the end of the first year with GFD. Twenty one patients were strictly compatible to GFD (group 1), and 16 patients were partly on GFD (group 2). Mean BMD levels was not statisticaly different at diagnosis and follow up between group 1 and 2. While the mean BMD of group 1 (0.4758 g/cm2 ) was significantly lower than control group (p= 0.014), no difference was found between group 2 and control group. Two patients who didn't strictly compatible to GFD, developed osteoporosis on follow up. Conclusion Bone mineral density can be restored with GFD. We consider BMD of all children with celiac disease should be evaluated at diagnosis and follow up until the end of growth up period. Due to increased risk of osteopenia and osteoporosis, they should be critically followed up, if they don't strictly compatible to GFD
Description
Keywords
Çölyak hastalığı, çocukluk çağı, kemik mineral dansitesi, osteoporoz, kemik metabolizması, bone metabolism, osteoporosis, bone mineral density, childhood, Celiac disease