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Evaluation of Micronutrient Deficiencies and Growth in Children with Celiac Disease

Suna Kaymak

Background: Celiac Disease (CD) is a serious autoimmune disease that occurs in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine and its destruction leads to malabsorption. Impaired growth and micronutrient deficiencies are a well-known complication in celiac disease.

Objective: We aimed to analyze growth status of children with CD and to compare with healthy subjects and to evaluate frequency of micronutrient deficiency in children with CD.

Patients and methods: We reviewed the medical records of 70 children with CD and 57 age and sex-matched healthy controls. Age and sex specific height, weight and Body Mass Index (BMI) standard deviation scores were calculated with national reference data. Growth retardation was defined as the Height for Age Z score (HAZ)<-2, undernutrition as the Weight for Age Z score (WAZ)<-2, severe malnutrition as the Body Mass Index Z score (BMIZ)<-2, and obesity was defined as BMIZ more than +2. Age, gender, medical and physical examination findings, laboratory tests, upper GI endoscopy and biopsy results were recorded for each patient.

Results: Seventy children with CD and 57 controls were enrolled no significant differences were found between the two groups in terms of age or gender. The mean WAZ, HAZ and BMIZ scores of the CD group were -1.2 ± 1.13, -0.92 ± 1.19 and -1.0 ± 1.14 respectively (Table 1). The mean WAZ, HAZ and BMIZ scores were significantly lower in the CD group compared to the control group (p<0.001, p<0.001 and p=0.005 respectively). The prevalence of undernutrition, growth retardation and chronic malnutrition in the CD patients were 24.3% (n=17), 17.1% (n=12) and 14.3% (n=10) respectively. Vitamin D, zinc, iron and vitamin A deficiency were most commonly observed in the children with CD (60%, 44.1%, 41.2% and 37.5% respectively).

Conclusion: Children admitted with celiac disease should be evaluated for nutritional status and micronutrient deficiencies.