The Effect of Gluten-free Diet on Cardiovascular Risk Factors in Newly Diagnosed Pediatric Celiac Disease Patients
Corresponding Author
Eyal Zifman
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Pediatric Gastroenterology Clinic, Pediatric Division, Meir Medical Center, Kfar-Saba
Address correspondence and reprint requests to Eyal Zifman, MD, Pediatric Gastroenterology Clinic, Meir Medical Center, 59th Tchernichovsky St, Kfar Saba 4464402, Israel (e-mail: [email protected]).Search for more papers by this authorOrith Waisbourd-Zinman
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Search for more papers by this authorLuba Marderfeld
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Clinical Nutrition and Dietetics Department, Schneider Children's Medical Center of Israel, Petach-Tikva
Search for more papers by this authorNoam Zevit
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Search for more papers by this authorAnat Guz-Mark
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Search for more papers by this authorAri Silbermintz
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Search for more papers by this authorAmit Assa
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Search for more papers by this authorYael Mozer-Glassberg
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Search for more papers by this authorNeta Biran
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Clinical Nutrition and Dietetics Department, Schneider Children's Medical Center of Israel, Petach-Tikva
Search for more papers by this authorDana Reznik
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Clinical Nutrition and Dietetics Department, Schneider Children's Medical Center of Israel, Petach-Tikva
Search for more papers by this authorIrit Poraz
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Clinical Nutrition and Dietetics Department, Schneider Children's Medical Center of Israel, Petach-Tikva
Search for more papers by this authorRaanan Shamir
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Search for more papers by this authorCorresponding Author
Eyal Zifman
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Pediatric Gastroenterology Clinic, Pediatric Division, Meir Medical Center, Kfar-Saba
Address correspondence and reprint requests to Eyal Zifman, MD, Pediatric Gastroenterology Clinic, Meir Medical Center, 59th Tchernichovsky St, Kfar Saba 4464402, Israel (e-mail: [email protected]).Search for more papers by this authorOrith Waisbourd-Zinman
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Search for more papers by this authorLuba Marderfeld
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Clinical Nutrition and Dietetics Department, Schneider Children's Medical Center of Israel, Petach-Tikva
Search for more papers by this authorNoam Zevit
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Search for more papers by this authorAnat Guz-Mark
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Search for more papers by this authorAri Silbermintz
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Search for more papers by this authorAmit Assa
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Search for more papers by this authorYael Mozer-Glassberg
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Search for more papers by this authorNeta Biran
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Clinical Nutrition and Dietetics Department, Schneider Children's Medical Center of Israel, Petach-Tikva
Search for more papers by this authorDana Reznik
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Clinical Nutrition and Dietetics Department, Schneider Children's Medical Center of Israel, Petach-Tikva
Search for more papers by this authorIrit Poraz
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Clinical Nutrition and Dietetics Department, Schneider Children's Medical Center of Israel, Petach-Tikva
Search for more papers by this authorRaanan Shamir
Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Search for more papers by this authorThe authors report no conflicts of interest.
ABSTRACT
Objectives:
Although gluten-free diet (GFD) is the only proven therapy for celiac disease (CD), its effect on cardiovascular disease (CVD) risk factors is still unclear. Our aim was to determine whether adherence to GFD affects CVD risk factors among newly diagnosed pediatric CD subjects.
Methods:
We prospectively enrolled pediatric subjects undergoing upper gastrointestinal endoscopy for suspected CD. We collected anthropometric and laboratory parameters related to CVD risk factors at the time of CD diagnosis and 1 year after initiation of a GFD and evaluated changes in CVD risk factors. Paired t tests or Wilcoxon nonparametric tests were used, each when appropriate.
Results:
One hundred ten newly diagnosed CD pediatric subjects were included in the analysis. There were 64 (58.2%) girls and the mean age at diagnosis was 6.8 ± 3.4 years. Median body mass index z scores (P = 0.84), rates of underweight or overweight (P = 0.32), and rates of elevated blood pressure (P = 0.78) remained unchanged. Although median fasting insulin levels increased (1.9 vs 5.4 μU/mL, P < 0.001), insulin resistance as measured by homeostatic model assessment did not increase after 1 year of GFD (P = 0.16). Although rates of dyslipidemia remained unchanged, median high-density lipoprotein levels increased on GFD (47 vs 51 mg/dL, P < 0.001).
Conclusions:
In this pediatric CD cohort, GFD for 1 year was not associated with increased CVD risk factors. The long-term significance of these mild changes is yet to be determined.
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