R Lillo

BONE MINERAL DENSITY (BMD) IN CHILDREN WITH CELIAC DISEASE (CD): ITS RELATION TO PUBERTY AND CALCIUM INTAKE

Abstract Bone mineral density (BMD) and calcium intake were studied in 39 celiac patients (CP) with good compliance for the gluten free diet in 39 healthy subjects, aged 6 to 16 years of age (17 prepuberal and 22 puberal) in a case-control design (1;1). Nutritional and statural adequacy were evaluated by means of the body mass index (BMI), and height for age (H/A) respectively, expressed as z score. BMD in the whole body, spine and hip was evaluated using a LUNAR densitometer in prepuberal and as puberal CD. Food intake was determined by 24 hours recall. Antiendomisium and anti-gliadin antibodies and bone age were also evaluated. Statural adequacy of celiacs was significantly lower (p

Effect of A 24 Months Calcium and Vitamin D Supplementation on Bone Mineralization in Coeliac Patients (CP)

Effect of A 24 Months Calcium and Vitamin D Supplementation on Bone Mineralization in Coeliac Patients (CP)

Growth and Bone Mineralization in Children With Cellac Disease (Cd). Effect of Calcium and Vitamin D Supplementation 10

Growth and Bone Mineralization in Children With Cellac Disease (Cd). Effect of Calcium and Vitamin D Supplementation 10

Efect of Calcium and Vitamin D Suplementation on Bone Mineralization (Bm) of Children With Coeliac Disease (Cd)

Efect of Calcium and Vitamin D Suplementation on Bone Mineralization (Bm) of Children With Coeliac Disease (Cd)

Bone Mineralization in Celiac Disease (Cd) in Children

An alteration of 25 OH Vit D metabolism and of enteric proteins participating in calcium transport, decrease calcium intestinal absorption and bone mineralization, in CD Growth and bone mineralization of 36 celiac children of both sexes, aged 6 to 16 years and with as an average of 5 years of satifactory compliance with the gluten fee diet were evaluated through a paired case, control study. Nutritional and growth status were studied through weight/height, body fat and height/age measurements, according to WHO charts. Dietary compliance was verified by determination of antigliadin and antiendomisium antibodies. Bone mineral density (BMD) was measured in the spine, hip and total body with a Lunar radiologic densitometer and results were expressed as Z score, using reference from healthy spanish children population. For statistical analysis student T test and relative risk were calculated. A significant lower statural adequation was obsserved in CD(96.6±5.5) compared with the controls (101.5±5.4) while no differences in ponderal adequation and body fat were detected. CD patients had significant lower BMD in total body, spine and femoral neck(-0.19±0.63.-0.92±0.98 and -0.3±0.99 respectivelly) than controls (0.47±0.64, 0.23±1.37 and 0.29-±1.09 respectivelly. CD patients were at increased risk of a bone mineralization below -1 s.d. in total body and spine (2.13 and 1.96 times respectivelly) than controls. These results indicate that children with CD are at high risk of developing osteoporosis in the adult life.

INFLUENCE OF PHYSICAL ACTIVITY ON SKELETAL MINERALIZATION

The achievement of an optimal peak bone mass in the second decade of life is the best protection against fractures later in life. Physical exercise contributes to maximal skeletal mineralization in adults. However in adolescents, physical activity (PA) can reduce skeletal mineralization in some sports, while it can improve it in others. The purpose of the present study was to analyze the influence of PA upon skeletal mineralization. This was evaluated by determining bone mineral density (BMD) in total body, lumbar spine and femoral neck, measured by double-photon isotopic absorptiometry (Norland). 144 school children of both sexes, between the ages of 7 and 14 years, with different degrees of PA were recruited. Results were expressed as the mean ± SEM and the level of significance was evaluated by the Student t and F test. With increased physical activity, higher BMD mean values in the femoral neck and the lumbar spine were observed in both sexes. If physical activity was increased, BMD was 110% of the normal standard for pubertal and 108% for prepubertal children. In pubertal school children with decreased PA, BMD was below the normal standard. These results suggest that PA increases skeletal mineralization in the lumbar spine and femoral neck, particularly during puberty.

BONE MINERALIZATION OF SCHOOL AGE CHILDREN ACCORDING TO CALCIUM INTAKE

Nutrition is one of the factors that influences bone mineralization (BM). We have shown that the Chilean teenager has a low calcium intake during a period of rapid calcium accretion, which may favor osteoporosis in adult life. Thus, we evaluated the influence of a low calcium intake on BM in school age children. We studied 36 children with calcium intakes below the recommended allowance (RDA) and 28 controls of the same age and sex with an adequate calcium intake. Calcium intake was measured by three 24 hour recollection surveys, the percentage of adequation of weight for height (W/H) according to WHO tables, and puberal development was assessed by the method of Tanner. Bone mineral density (BMD) and total bone mass (TBM) were determined in whde body, spine and hip, with a Norland densitometer (Gd 156). The group with calcium intake below 50% had a lower % of adequation of height for age (97.7 ± 4.0%), TBM (98.9 ± 17.9) and BMD (97.8 ± 11.1%) in whole body compared with the group with intake over 100% (115.9 ± 17.4; 109.7 ± 18.0 and 104.7 ± 11.1%, respectively). In spine and hip there was a clear tendency for a lower TBM and BMD, which did not reach statistical significance. The recollection survey showed a lower protein intake in the group with low calcium intake compared with controls. The influence of isolated calcium deficit or in combination with protein deficit upon skeletal mineralization is discussed.

16 BONE MINERALIZATION IN PATIENTS WITH TURNER SYNDROME.

Turner Syndrome (TS) is associated with multiple malformations and skeletal abnormalities, including an alteration in bone mineralization (BM), present since infancy. We were interested in evaluating the current state of BM in TS patients. 30 patients (6 8/12 - 17 3/12 years) with cariotype certification of TS were studied. Antropometric characteristic were evaluated at birth and at the time of the study. In all of them, BM of whole body, spine and hip (femoral neck, trocanter and Wards triangle) was performed using adual photon isotopic densitometer (Norland). They were compared with 93 normal girls of same ages. TS patients had lower weight and height at birth, a lower H/A and higher W/H adequation than controls, with significant difference. The percentage of adequations of BM of whole body in total bone mass (TBM) and bone mineral density (BMD) was significatively lower than in controls (63,0 ± 12,8 vs. 100,0 ± 18,6 and 87,3 ± 10,4 vs 100,1 ± 10,8 respectively). At spine level there were significative differences in TBM, BMC and BMD (72,2 ± 15,2 vs 100,0 ± 19,8; 81,1 ± 15.3 vs 100,0 ± 16,2 and 89,5 ± 16,2 vs 100,0 ± 15.7 respectively). In hip (neck, trocanter and Wards triangle) the same high significative differences were observed. Stratificating the patients according to age, those under 10 6/12 years have a significantly lower BM, being these girls a risk group of severe osteoporosis and fractures in adult life.