Atherosclerotic Risk Factors in Children with Celiac Disease

Introduction and Objectives. Celiac disease (CD) is a complex autoimmune disorder occurring in genetically susceptible individuals. There is limited data on the impact of gluten-free diet (GFD) on the risk of developing cardiovascular diseases. Hereby, we present our study regarding the impact of tr...

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Main Authors: Anna Rybak, Aldona Wierzbicka, Piotr Socha, Anna Stolarczyk, Bożena Cukrowska, Łukasz Obrycki, Zbigniew Wawer, Roman Janas, Beata Oralewska, Anna Szaflarska-Popławska, Barbara Iwańczak, Elżbieta Cyrta-Jarocka, Urszula Grzybowska-Chlebowczyk, Wojciech Cichy, Grażyna Czaja-Bulsa, Jerzy Socha
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2020/6138243
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author Anna Rybak
Aldona Wierzbicka
Piotr Socha
Anna Stolarczyk
Bożena Cukrowska
Łukasz Obrycki
Zbigniew Wawer
Roman Janas
Beata Oralewska
Anna Szaflarska-Popławska
Barbara Iwańczak
Elżbieta Cyrta-Jarocka
Urszula Grzybowska-Chlebowczyk
Wojciech Cichy
Grażyna Czaja-Bulsa
Jerzy Socha
author_facet Anna Rybak
Aldona Wierzbicka
Piotr Socha
Anna Stolarczyk
Bożena Cukrowska
Łukasz Obrycki
Zbigniew Wawer
Roman Janas
Beata Oralewska
Anna Szaflarska-Popławska
Barbara Iwańczak
Elżbieta Cyrta-Jarocka
Urszula Grzybowska-Chlebowczyk
Wojciech Cichy
Grażyna Czaja-Bulsa
Jerzy Socha
author_sort Anna Rybak
collection DOAJ
description Introduction and Objectives. Celiac disease (CD) is a complex autoimmune disorder occurring in genetically susceptible individuals. There is limited data on the impact of gluten-free diet (GFD) on the risk of developing cardiovascular diseases. Hereby, we present our study regarding the impact of treatment with GFD on the biochemical risk factors of atherosclerosis. Material and Methods. 277 patients with CD from 7 Polish clinics were enrolled in the study (210 children treated for at least 5 years and 67 children included in the study on the day of CD diagnosis and observed for 1 year on a GFD). We obtained selected clinical data, and we assessed lipid profile, apolipoproteins (A1, B, and E), lipoprotein (a), homocysteine, as well as antioxidants (folic and uric acid), and high-sensitivity CRP (hsCRP) for all patients. The compliance to GFD was verified using anti-transglutaminase antibodies and deamidated gliadin peptide antibodies. As a reference group, the data of 95 healthy children recruited for another project was used, for which we had the results of selected parameters. Results. We found significantly lower concentrations of total cholesterol, lipoprotein LDL-C, apolipoproteins A1 and B, as well as hCRP in all children with CD. We showed decreased level (<5 ng/mL) of folic acid among 46% of children treated for >5 years. Moreover, we showed significant decrease of folic acid level already after 1 year of a GFD (12 vs. 5.6 ng/mL; p<0.001). We also found significant negative correlation of z-score body mass index (BMI) with HDL and APOA1 level (r=−0.33; p=0.015 and r=−0.28; p=0.038, respectively) and modest positive correlation of z-score BMI with atherogenic factor of total cholesterol-HDL ratio and LDL-HDL ratio (r=0.40; p=0.002 and r=0.36; p=0.006, respectively). Analysis of physical activity showed an increase in the insulin levels with inactivity (r=0.36; p=0.0025). We also found positive correlation of the sleep duration with the adiponectin level (r=0.41; p=0.011). Conclusions. In children with CD treated with a GFD, decreased level of folic acid together with increased BMI, sedentary behavior, and an improper lipid profile may predispose them to atherosclerosis in the long run. This data suggests the need of further studies to determine the need for metabolic cardiovascular risk screening in children with CD.
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spelling doaj-art-1fc1f4f92a5d4473aa00a522ecde1b722025-02-03T06:08:07ZengWileyGastroenterology Research and Practice1687-61211687-630X2020-01-01202010.1155/2020/61382436138243Atherosclerotic Risk Factors in Children with Celiac DiseaseAnna Rybak0Aldona Wierzbicka1Piotr Socha2Anna Stolarczyk3Bożena Cukrowska4Łukasz Obrycki5Zbigniew Wawer6Roman Janas7Beata Oralewska8Anna Szaflarska-Popławska9Barbara Iwańczak10Elżbieta Cyrta-Jarocka11Urszula Grzybowska-Chlebowczyk12Wojciech Cichy13Grażyna Czaja-Bulsa14Jerzy Socha15Department of Gastroenterology, The Great Ormond Street Hospital, London, UKDepartment of Biochemistry and Experimental Medicine, Children’s Memorial Health Institute, Warsaw, PolandDepartment of Gastroenterology, Hepatology and Feeding Disorders, Children’s Memorial Health Institute, Warsaw, PolandDepartment of Gastroenterology, Hepatology and Feeding Disorders, Children’s Memorial Health Institute, Warsaw, PolandDepartment of Pathology, Children’s Memorial Health Institute, Warsaw, PolandDepartment of Nephrology, Kidney Transplantation and Arterial Hypertension, The Children’s Memorial Health Institute, Warsaw, PolandDepartment of Biochemistry and Experimental Medicine, Children’s Memorial Health Institute, Warsaw, PolandDepartment of Biochemistry and Experimental Medicine, Children’s Memorial Health Institute, Warsaw, PolandDepartment of Biochemistry and Experimental Medicine, Children’s Memorial Health Institute, Warsaw, PolandDepartment of Pediatrics, Allergology and Gastroenterology, Collegium Medicum Nicolaus Copernicus University, Bydgoszcz, PolandDepartment of Pediatrics, Gastroenterology and Nutrition, Medical University of Wroclaw, Wroclaw, PolandDepartment of Pediatrics, Gastroenterology and Allergology, Medical University, Białystok, PolandDepartment of Gastroenterology, Department of Pediatrics, Upper-Silesia Center of Children’s Health, Katowice, PolandDepartment of Pediatrics, Gastroenterology and Metabolic Diseases, University of Medical Sciences, Poznan, PolandDepartment of Pediatrics, Gastroenterology and Rheumatology, Independent Specialist Public Health Care, Szczecin, PolandDepartment of Gastroenterology, Hepatology and Feeding Disorders, Children’s Memorial Health Institute, Warsaw, PolandIntroduction and Objectives. Celiac disease (CD) is a complex autoimmune disorder occurring in genetically susceptible individuals. There is limited data on the impact of gluten-free diet (GFD) on the risk of developing cardiovascular diseases. Hereby, we present our study regarding the impact of treatment with GFD on the biochemical risk factors of atherosclerosis. Material and Methods. 277 patients with CD from 7 Polish clinics were enrolled in the study (210 children treated for at least 5 years and 67 children included in the study on the day of CD diagnosis and observed for 1 year on a GFD). We obtained selected clinical data, and we assessed lipid profile, apolipoproteins (A1, B, and E), lipoprotein (a), homocysteine, as well as antioxidants (folic and uric acid), and high-sensitivity CRP (hsCRP) for all patients. The compliance to GFD was verified using anti-transglutaminase antibodies and deamidated gliadin peptide antibodies. As a reference group, the data of 95 healthy children recruited for another project was used, for which we had the results of selected parameters. Results. We found significantly lower concentrations of total cholesterol, lipoprotein LDL-C, apolipoproteins A1 and B, as well as hCRP in all children with CD. We showed decreased level (<5 ng/mL) of folic acid among 46% of children treated for >5 years. Moreover, we showed significant decrease of folic acid level already after 1 year of a GFD (12 vs. 5.6 ng/mL; p<0.001). We also found significant negative correlation of z-score body mass index (BMI) with HDL and APOA1 level (r=−0.33; p=0.015 and r=−0.28; p=0.038, respectively) and modest positive correlation of z-score BMI with atherogenic factor of total cholesterol-HDL ratio and LDL-HDL ratio (r=0.40; p=0.002 and r=0.36; p=0.006, respectively). Analysis of physical activity showed an increase in the insulin levels with inactivity (r=0.36; p=0.0025). We also found positive correlation of the sleep duration with the adiponectin level (r=0.41; p=0.011). Conclusions. In children with CD treated with a GFD, decreased level of folic acid together with increased BMI, sedentary behavior, and an improper lipid profile may predispose them to atherosclerosis in the long run. This data suggests the need of further studies to determine the need for metabolic cardiovascular risk screening in children with CD.http://dx.doi.org/10.1155/2020/6138243
spellingShingle Anna Rybak
Aldona Wierzbicka
Piotr Socha
Anna Stolarczyk
Bożena Cukrowska
Łukasz Obrycki
Zbigniew Wawer
Roman Janas
Beata Oralewska
Anna Szaflarska-Popławska
Barbara Iwańczak
Elżbieta Cyrta-Jarocka
Urszula Grzybowska-Chlebowczyk
Wojciech Cichy
Grażyna Czaja-Bulsa
Jerzy Socha
Atherosclerotic Risk Factors in Children with Celiac Disease
Gastroenterology Research and Practice
title Atherosclerotic Risk Factors in Children with Celiac Disease
title_full Atherosclerotic Risk Factors in Children with Celiac Disease
title_fullStr Atherosclerotic Risk Factors in Children with Celiac Disease
title_full_unstemmed Atherosclerotic Risk Factors in Children with Celiac Disease
title_short Atherosclerotic Risk Factors in Children with Celiac Disease
title_sort atherosclerotic risk factors in children with celiac disease
url http://dx.doi.org/10.1155/2020/6138243
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