Co-occurrence of Gluten-free Diet Adherence on Bone Mineral Density and Growth in Children with Celiac Disease.

Abstract

To investigate the impact of gluten-free diet adherence on bone mineral density and growth in children with celiac disease.This retrospective cross-sectional study reviewed the medical records of 75 pediatric patients diagnosed with celiac disease. Data on adherence to a gluten-free diet, bone mineral density assessed by dual-energy X-ray absorptiometry, anthropometric measurements, and laboratory parameters were collected. Bone mineral density was evaluated using Z-scores, and low bone mass for age was defined as a bone mineral density Z-score of<-2 according to International Society for Clinical Densitometry pediatric guidelines.Of the 75 patients, 26 (34.7%) patients were men and 49 (65.3%) patients were women; 48 (64%) patients adhered to the diet and 27 (36%) patients did not. Most patients (96%) had normal bone mineral density Z-scores, while 3 (4%) patients had low bone mass for age. The mean height was 141.09±19.34 cm and the mean weight was 37.50±14.95 kg. Growth failure was observed in 10.6% for height, 21.3% for weight, and 5.3% for both. No significant association was observed between diet adherence and sex, bone mineral density findings, growth failure, or most laboratory parameters. Ferritin levels were significantly higher in adherent patients, and positive correlations were observed between diet adherence and hemoglobin and ferritin levels.Adherence to a gluten-free diet showed a trend toward higher bone mineral density Z-scores but without statistically significant differences. The low prevalence of low bone mass for age may limit the detection of differences between groups. Prospective longitudinal studies are needed to clarify the long-term impact of dietary adherence on bone health in pediatric celiac disease.