Prevalence of and Risk Factors for Low Bone Mineral Density in Children With Celiac Disease.

TitlePrevalence of and Risk Factors for Low Bone Mineral Density in Children With Celiac Disease.
Publication TypeJournal Article
Year of Publication2019
AuthorsWebster J, Vajravelu MEllen, Choi C, Zemel B, Verma R
JournalClin Gastroenterol Hepatol
Volume17
Issue8
Pagination1509-1514
Date Published2019 Jul
ISSN1542-7714
Abstract

BACKGROUND & AIMS: Celiac disease can reduce bone mineral density. We sought to determine the prevalence and risk factors for low areal bone mineral density (aBMD) in children with celiac disease.

METHODS: We performed a retrospective cohort study of 673 children with celiac disease (63% female; median age at diagnosis, 10.6 y; interquartile range, 7.8-13.9) who underwent dual x-ray absorptiometry (DXA) from 2009 through 2016 at the Children's Hospital of Philadelphia. We collected demographic, clinical, and laboratory data from medical records. We performed logistic regression analysis to identify factors associated with low (Z less than -2) lumbar spine aBMD Z (aBMD-Z) scores at initial and subsequent tests.

RESULTS: The time between diagnosis of celiac disease and first DXA was 0 days (interquartile range, -11 to 31 d). The mean aBMD-Z score at the children's initial scan was -0.4 ± 1.2; 46 children had aBMD-Z scores less than -2 (6.8%; 95% CI, 5.2%-9.0%). Those who had a second DXA analysis (n = 108; 16.0%) had a significant increase in aBMD-Z score (mean change, 0.29; P = .0005). Higher body mass index (BMI) was associated with lower odds of a low aBMD-Z score at the initial DXA analysis (odds ratio, 0.46, 95% CI, 0.35-0.50). BMI-Z scores greater than -0.4 identified children with a low aBMD-Z at their initial DXA analysis with a 95% negative predictive value.

CONCLUSIONS: Approximately 7% of subjects with celiac disease had a low aBMD-Z score, determined by DXA, at the time of diagnosis; this value was nearly 3-fold higher than expected from a population of children of this age and sex distribution. BMI-Z scores could be used to identify children with celiac disease at risk for low BMD who should receive DXA screening.

DOI10.1016/j.cgh.2018.10.035
Alternate JournalClin. Gastroenterol. Hepatol.
PubMed ID31230659
Grant ListK12 DK094723 / DK / NIDDK NIH HHS / United States