Celiac.com 11/07/2011 - Fat-soluble vitamin malabsorption, inflammation and/or under-nutrition put children with celiac disease at risk for decreased bone mineral density.

A research team recently set out to determine how vitamin D and K might influence bone mineral density and bone growth in children and adolescents with celiac disease. The study team included D. R. Mager, J. Qiao, and J. Turner.

The team's goal was to examine the interrelationships between vitamin K/D levels and lifestyle factors on bone mass density in children and adolescents with celiac disease at diagnosis and after 1 year on the gluten-free diet.

The team studied children and adolescents aged 3–17 years with biopsy proven celiac disease at diagnosis and after 1 year on the gluten-free diet.

To measure bone mineral density the researchers used dual-energy X-ray absorptiometry, factoring in relevant variables including anthropometrics, vitamin D/K status, diet, physical activity and sun exposure.

The children saw their lowest BMD-z scores for whole-body and lumbar-spine (−1) at diagnosis (10–20%) and after 1 year (30–32%), independent of symptoms.

Older children (>10 years) showed substantially lower BMD-z scores for whole-body (−0.55±0.7 versus 0.72±1.5) and serum levels of 25(OH) vitamin D (90.3±24.8 versus 70.5±19.8 nmol/l) 
as compared with younger children (10 years) (P<0.001).

Overall, forty-three percent showed suboptimal vitamin D status (25(OH)-vitamin D <75 nmol/l) at diagnosis. Nearly half of these vitamin D deficiencies corrected after 1 year on the gluten-free diet.

Also, twenty-five percent of the children showed suboptimal vitamin K status at diagnosis. All vitamin K deficiencies resolved after 1 year.

Both children and adolescents with celiac disease face a substantial risk for suboptimal bone health at time of diagnosis and up to 1 year after adopting a gluten-free diet. This higher risk is likely due in part to suboptimal vitamin D/K levels.

Children and teens with celiac disease may benefit from treatment regimens that promote optimal vitamin K/D intake.

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