On diagnosis, children with celiac had three times the normal risk for low bone mineral density in a study at The Children’s Hospital of Philadelphia, Pennsylvania. The risk mainly concerns children with low body mass index. Patients who received a repeat X-ray showed a significant improvement, probably due to following a gluten-free diet. The study did not find any benefit to rescreening those with good bone density on the first test.
Untreated celiac can cause poor absorption of calcium, hindering bone development. However, most gastroenterologists do not screen children with celiac for low bone mineral density because there has been a lack of supportive research. Previous studies were small and did not highlight additional risk factors to help doctors know which patients were at risk.
This study considered previous medical records from 673 children with celiac who underwent X-rays between 2009 and 2016 at the hospital. Seven percent had low bone mineral density. Among children with low body mass index, the prevalence was 10 percent, almost three times higher than for those with normal body weight. This suggests body mass index could be used to indicate a need for X-rays. Further study will be necessary to clarify the prevalence of bone problems by following new patients from diagnosis through treatment and follow-up.
Webster J, Vajravelu ME, Choi C, Zemel B and Verma R, “Prevalence of and risk factors for low bone mineral density in children with celiac disease,” Clinical Gastroenterology and Hepatology, 30 Nov 2018, doi:10.1016/j.cgh.2018.10.035.
Van Waffle is a freelance journalist in Waterloo, Canada, and research editor for Gluten-Free Living. He blogs at vanwaffle.com.