Evaluation of micronutrient deficiencies and growth in children with celiac disease

Abstract

Objective: Growth retardation and micronutrient deficiencies are well-known complications of celiac disease (CD). In this study, it was aimed primarily to evaluate the nutritional and growth status of patients with celiac disease and to compare them with healthy children, and secondarily to examine the effect of dietary compliance on feeding and growth status in these patients. Material and Methods: The study was conducted between June 2017 and December 2019. Celiac patients were grouped as newly diagnosed and follow-up. Follow up children with celiac disease were chosen from at least one-year disease follow-up and grouped into two according to their compliance to gluten-free diet. The patients' sociodemographic and anthropometric features and laboratory values were recorded. Growth retardation was considered if height-for-age z-scores (HAZ) were below -2; undernutrition if weight-for-age z-scores were below -2, severe malnutrition if weight-for-age z-scores (WAZ) were below -2 and obesity was considered if body mass index z scores (BMIZ) were above +2. Results: Seventy celiac patients and 57 healthy children were included in the study. The prevalence of malnutrition, growth retardation and chronic malnutrition in celiac patients was 24.3%, 17.1% and 14.3%, respectively. The mean YVZ, YBZ and BMI scores of the celiac group were -1.2, -0.92 and -1.0, respectively, and were significantly lower than those of the control group, while this difference was partially closed in patients with good dietary compliance. Vitamin D, zinc, iron and vitamin A deficiencies were the most common micronutrient deficiencies in patients with celiac disease. Conclusion: Our study revealed that although growth retardation can be seen in patients with celiac disease at diagnosis, there was no growth retardation in most of the our patients, catch up growth did not occur in some patients with CD, and the frequency of micronutrient deficiencies were high in both newly diagnosed and followed-up celiac patients.