Celiac disease (CD) is a common condition with wide clinical variation in both severity and type of symptoms. Many complications have been reported to occur.
However, the protective effect of a gluten free diet (GFD) remains controversial.
In this study, researchers from Edinburgh, Scotland, assessed the prevalence of complications, and the effect of a strict GFD in a large population with CD.
The team invited consecutive patients attending the celiac clinic at the Western General Hospital, Edinburgh, to participate.
They collected data from case notes and questionnaires. This information was entered onto a secure database.
|Low birth weight babies in patients with celiac disease:|
- Patients on gluten = 22%
- Gluten free diet = 4%
Overall, clinical data were obtained from 270 patients and questionnaires completed by 199.
The research team determined that the median age at diagnosis was 41.5 years. The sex ratio of study participants was 1 male to 2.6 females.
Median follow-up 6 years.
The team found that 91% of patients reported symptoms of various severity, while 9% were asymptomatic, even when considered in retrospect.
Researchers determined that 38% were anemic at diagnosis. This improved to 13% with treatment.
Furthermore, 16% of patients were vitamin B12 deficient and 53% were iron deficient at diagnosis.
Overall, 22% had osteoporosis of the hip and 42% of the spine at diagnosis. This improved to 12% and 31% with treatment.
However, the team found that those patients with strict compliance to a GFD had significantly higher T scores on a DEXA scan of the neck of the femur, compared to those who did not. T scores of the spine were not significantly different.
Epilepsy occurred in 9 patients. This was not more common in patients adhering to a less strict GFD, but in 7 cases the diagnosis of epilepsy was made before that of CD.
In addition, low birth weight (LBW) babies (< 2.5 kg) occurred in 5 out of 23 pregnancies in those regularly taking gluten. This compared with 6 out of 146 pregnancies in those on a strict diet.
The team also found that osteoporosis and anemia did not differ in the symptomatic group, but LBW babies did (11 out of 221 pregnancies versus 5 out of 24).
Dr Gillett concluded, "Complications occur commonly in celiac disease".
However, "The risk of osteoporosis of the hip and LBW babies may be prevented by strict GFD".