(10/08)
Coeliacs often have an altered calcium (Ca2+) metabolism that can cause osteopenia, a bone mass decrease due to the impaired absorption of this mineral. This can lead to osteoporosis in 35–85% of cases. This phenomenon is particularly frequent among late-diagnosed adult coeliacs but can also be present in children.
Currently coeliacs need regular laboratory and radiology examinations to monitor the situation, but recent research carried out at the paediatric clinic of the University of Trieste, IRCCS Burlo Garofolo (an institute specialising in child health) suggests that they may not be necessary for children.
Impaired bone mineralisation in coeliacs is caused partly by a failure to absorb vitamin D and calcium and partly by the presence of a chronic inflammatory condition. It is widely accepted that, among adults, a gluten-free diet alone is not sufficient to make the bone damage regress. However, in children, as the study demonstrated, this may not be the case.
Fifty-eight child coeliacs who had an impaired bone metabolism and mineralisation and 60 healthy children were monitored by the medical staff of the Burlo Garofolo over 6–12 month period. At the end of the first six months, it became clear that the gluten-free diet alone was enough to normalise their bone condition.
As Alessandro Ventura, the director of the clinic, says, paediatricians should focus on a strict observance of the gluten-free diet. In doing this, apart from saving the cost of on-going examinations, the exposure of young children to radiation such as that used in DEXA, mild as it may be, is avoided.
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More research on the management of coeliac disease
