Bone Mineral Densitometry Findings of Children with Newly Diagnosed Celiac Disease

AbstractThe aim of this study was (1) to prospectively evaluate the nationwide implementation of the ESPGHAN-guidelines for the diagnosis of celiac disease (CD), (2) to investigate the incidence and clinical presentation of diagnosed childhood CD (0–14 years) in the Netherlands, and (3) to compare the findings with national survey data from 1975 to 1990 and 1993 to 2000 using the same approach. From 2010 to 2013, all practicing paediatricians were invited to report new celiac diagnoses to the Dutch Pediatric Surveillance Unit. Data were collected via questionnaires. A total of 1107 children with newly diagnosed CD were reported (mean age, 5.8 years; range, 10 months–14.9 years; 60.5% female). After the introduction of the non-biopsy approach in 2012, 75% of the diagnoses were made according to the guideline with a significant decrease of 46.3% in biopsies. The use of EMA and HLA-typing significantly increased with 25.8% and 62.1%, respectively. The overall incidence rate of childhood CD was 8.8-fold higher than in 1975–1990 and 2.0-fold higher than in 1993–2000. During the study period, the prevalence of diagnosed CD was 0.14%, far below 0.7% of CD identified via screening in the general Dutch paediatric population. Clinical presentation has shifted towards less severe and extra-intestinal symptoms.Conclusion: ESPGHAN guidelines for CD diagnosis in children were effectively and rapidly implemented in the Netherlands. Incidence of diagnosed CD among children is still significantly rising with a continuous changing clinical presentation. Despite the increasing incidence of diagnoses, significant underdiagnosis still remains. What is Known:• Since 2000 the incidence of diagnosed childhood CD in the Netherlands has shown a steady rise.• The rise in incidence has been accompanied by a changing clinical presentation at diagnosis. What is New:• The ESPGHAN guidelines 2012 for CD diagnosis were effectively and rapidly implemented in the Netherlands.• The incidence of diagnosed childhood CD in the Netherlands has continued to rise significantly during the reported period.

Download Full-text

Nutritional Status in Spanish Adults with Celiac Disease Following a Long-Term Gluten-Free Diet Is Similar to Non-Celiac

Nutrients ◽

10.3390/nu13051626 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1626

Author(s):

Catalina Ballestero-Fernández ◽

Gregorio Varela-Moreiras ◽

Natalia Úbeda ◽

Elena Alonso-Aperte

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Celiac Disease ◽

Vitamin E ◽

Nutritional Status ◽

Bone Mineral ◽

Biochemical Parameters ◽

Gluten Free ◽

Mineral Density

The only available treatment for celiac disease is life-long gluten exclusion. We conducted a cross-sectional age- and gender-matched study in 64 celiac adults on a long-term (>1 year) gluten-free diet and 74 non-celiac volunteers from Spain, using dietary, anthropometric, and biochemical parameters, as well as assessing bone mineral density and physical activity. Celiac adults had deficient intake (below 2/3 of the recommended intake) for folates, vitamin E, and iodine and low intake of calcium (below 80% of the recommended intake). Iron intake was also below 2/3 of the recommended intake in celiac women. Vitamin D intake was extremely low, and 34% of celiac patients had moderately deficient plasma levels. According to bone mineral density, celiac women may be more prone to osteopenia and osteoporosis. However, we found a perfectly analogous nutritional status scenario in celiac as compared to healthy volunteers, with the dietary deviations found being similar to those of the Spanish population, i.e., both groups followed a high-lipid, high-protein, and low-carbohydrate diet. Values for biochemical parameters were found within the reference ranges. Celiac disease had no influence on body weight, but body fat in celiac patients tended to be higher. According to our results, vitamin D, calcium, folates, vitamin E, iodine, and iron nutritional status should be specifically assessed and monitored in the celiac population.

Download Full-text

The Prevalence of Anti-Zein Antibodies: A Comparative Study between Celiac Disease and Irritable Bowel Syndrome

Nutrients ◽

10.3390/nu13020649 ◽

2021 ◽

Vol 13 (2) ◽

pp. 649

Author(s):

Luis Alberto Sánchez-Vargas ◽

Karina Guadalupe Hernández-Flores ◽

Francisco Javier Cabrera-Jorge ◽

José María Remes-Troche ◽

Job Reyes-Huerta ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Celiac Disease ◽

Gastrointestinal Disorder ◽

Newly Diagnosed ◽

Disease Group ◽

Immune Mediated ◽

Healthy Control ◽

Gliadin Peptides ◽

Irritable Bowel ◽

First Time

Celiac disease (CD) is a chronic immune-mediated enteropathy triggered by exposure to dietary gluten in genetically predisposed individuals. In contrast, irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder affecting the large intestine, without an autoimmune component. Here, we evaluated the prevalence of IgA and IgG antibodies to maize zeins (AZA) in patients with CD and IBS. Using an in-house ELISA assay, the IgA and IgG anti-zein antibodies in the serum of 37 newly diagnosed CD (16 biopsy proved and 21 serological diagnosis) and 375 IBS patients or 302 healthy control (HC) subjects were measured. Elevated levels of IgA AZA were found in CD patients compared with IBS patients (p < 0.01) and HC (p < 0.05). CD patients had the highest prevalence (35.1%), followed by IBS (4.3%) and HCs (2.3%) (p < 0.0001). IgG AZA antibodies were not found in any CD patients, IBS patients, or HC subjects. A significant positive correlation was found between IgA AZA with IgA anti-gliadin (AGA, r = 0.34, p < 0.01) and IgA anti-deaminated gliadin peptides (DGP, r = 0.42, p < 0.001) in the celiac disease group. Taken together, our results show for the first time a higher prevalence of AZA IgA antibodies in newly diagnosed CD patients than in IBS patients, confirming a biased immune response to other gliadin-related prolamins such as maize zeins in genetically susceptible individuals.

Download Full-text

Bone Mineral Densitometry

Annals of Internal Medicine ◽

10.7326/0003-4819-107-6-932 ◽

1987 ◽

Vol 107 (6) ◽

pp. 932 ◽

Cited By ~ 20

Keyword(s):

Bone Mineral ◽

Bone Mineral Densitometry

Download Full-text

Circulating Extracellular Vesicles, A Novel Mechanism of Endocrine Cellular Cross-Talk, are Increased in Newly Diagnosed Celiac Disease Patients

Gastroenterology ◽

10.1016/s0016-5085(17)30590-5 ◽

2017 ◽

Vol 152 (5) ◽

pp. S71

Author(s):

Konstantinos Efthymakis ◽

Giuseppina Bologna ◽

Paola Lanuti ◽

Angelo Milano ◽

Francesco Laterza ◽

...

Keyword(s):

Celiac Disease ◽

Extracellular Vesicles ◽

Cross Talk ◽

Newly Diagnosed

Download Full-text

Intravenous Zoledronic Acid 5 mg on Bone Turnover Markers and Bone Mineral Density in East China Subjects with Newly Diagnosed Osteoporosis: A 24-month Clinical Study

Orthopaedic Surgery ◽

10.1111/os.12307 ◽

2017 ◽

Vol 9 (1) ◽

pp. 103-109 ◽

Cited By ~ 4

Author(s):

Bo-cheng Liang ◽

Zhen-yu Shi ◽

Bo Wang ◽

Peng Wu ◽

Ling-cheng Kong ◽

...

Keyword(s):

Bone Mineral Density ◽

Clinical Study ◽

Zoledronic Acid ◽

Bone Turnover ◽

Bone Mineral ◽

Bone Turnover Markers ◽

East China ◽

Newly Diagnosed ◽

Mineral Density ◽

Turnover Markers

Download Full-text

LOW BONE MINERAL DENSITY IN BRAZILIAN PATIENTS AT DIAGNOSIS OF CELIAC DISEASE

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032015000300004 ◽

2015 ◽

Vol 52 (3) ◽

pp. 176-179 ◽

Cited By ~ 3

Author(s):

Joyce Timmermans Pires da SILVA ◽

Renato M NISIHARA ◽

Luís Roberto KOTZE ◽

Márcia OLANDOSKI ◽

Lorete Maria da Silva KOTZE

Keyword(s):

Bone Mineral Density ◽

Celiac Disease ◽

Bone Mineral ◽

Disease Diagnosis ◽

Bone Fragility ◽

Mineral Density ◽

X Ray ◽

Low Bone Mineral Density ◽

Celiac Disease Diagnosis ◽

Male Subjects

BackgroundLow bone mineral density is considered an extra-intestinal manifestation of celiac disease with reduced bone mass, increased bone fragility, and risk of fractures. Celiac disease is considered a condition at high risk for secondary osteoporosis and the evaluation of bone density is very important in the clinical management of these patients.ObjectiveThe present study aimed to investigate bone alterations in celiac patients from Curitiba, South Region of Brazil at diagnosis, correlating the findings with age and gender.MethodsPatients who were included in the study were attended to in a private office of the same physician from January 2009 to December 2013. The diagnosis of celiac disease was done through clinical, serological and histological findings. All data were collected from the medical charts of the patients. After the diagnosis of celiac disease, evaluation for low bone mineral density was requested by dual-energy X-ray absorptiometry (DEXA). DEXA bone densitometer was used to estimate low bone mineral density at the lumbar spine and femur.ResultsA total of 101 patients, 82 (81.2%) female and 19 (18.8%) male subjects, with mean age of 39.0±3.03 years were included. At celiac disease diagnosis, 36 (35.6%) were younger than 30 years, 41 (40.6%) were between 31 and 50 years, and 24 (23.8%) were older than 50 years. Among the evaluated patients, 69 (68.3%) presented low bone mineral density, being 47% with osteopenia and 32% with osteoporosis. Patients who were older than 51 years and diagnosed with celiac disease presented low bone mineral density in 83.3% (20/24) of the cases. As expected, age influenced significantly the low bone mineral density findings. Among women, low bone mineral density was present with high frequency (60%) from 30 to 50 years. In patients diagnosed older than 60 years (n=8), all the women (n=5) and two of the three men had osteoporosis.ConclusionThis study demonstrated that 69% of Brazilian patients with celiac disease at diagnosis had low bone mineral density, being more frequent in women older than 50 years.

Download Full-text