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.
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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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