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The effect of celiac disease and gluten-free diet on pubertal development: a two-center study

  • Nevzat Aykut Bayrak ORCID logo EMAIL logo , Burcu Volkan , Belma Haliloglu , Soner Sertan Kara and Atilla Cayir
Published/Copyright: February 17, 2020

Abstract

Objectives

We aimed to assess whether age at menarche and pubertal development (Tanner stage) are related to gluten-free diet (GFD) adherence, hormonal status, micro-nutrient levels and body mass index (BMI) in children with celiac disease (CD).

Methods

In this two-center, cross-sectional study, CD patients and healthy individuals were studied. CD patients were re-evaluated after 1 year of follow-up. Height, weight, Tanner stage, age at menarche and diet compliance were recorded. Blood samples for anti-tissue transglutaminase IgA (TTG), pituitary gonadotropins, gonadal hormones, prolactin and micronutrients (folate, vitamin B12, vitamin D, ferritin, iron and, iron-binding capacity [IBC]) were assayed.

Results

Consecutive age- and sex-matched 228 celiac patients (12.92 ± 2.35 years; 67.9% female) and 135 non-celiac healthy individuals (12.77 ± 2.25 years; 65.2% female) were studied. Tanner stage was significantly higher in the control group for both girls and boys (p < 0.05). The mean age at menarche was significantly lower in healthy individuals (13.13 ± 1.01 vs. 12.15 ± 0.97, p < 0.001). By multivariate analysis, GFD adherence, transferrin saturation (sTrf), total IBC (TIBC) and vitamin D status were found to be positively correlated with Tanner stage (p < 0.05). After 1 year, 192 of the CD patients were re-evaluated. GFD compliance was better (TTG levels: 135.59 ± 73.88 vs. 71.53 ± 69.40, p < 0.001) and it was correlated with Tanner stage (r = 0.49, p < 0.01), sTrf (r = 0.66, p < 0.01) and IBC (r = 0.23, p < 0.05).

Conclusions

Our data show that adequate weight gain, adherence to GFD, sufficient iron and vitamin D status are essential factors for salubrious puberty in CD patients.


Corresponding author: Nevzat Aykut Bayrak, MD, Zeynep Kamil Women and Children’s Hospital, Department of Pediatric Gastroenterology, Istanbul, Turkey; and Pediatric Gastroenterology, Hepatology and Nutrition, Diyarbakir Children’s Hospital, Diyarbakir, Turkey, Phone: +902163910680/1909

Acknowledgments

None.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission. N.A.B. planned the study, wrote the initial draft, collected and analyzed the data, and revised and finalized the manuscript; B.V. planned the study, collected the data, wrote the initial draft and critically revised the manuscript; B.H. collected the data and revised the manuscript; S.S.K. collected the data and revised the manuscript; A.H. planned the study, collected the data and critically revised the manuscript.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2019-08-14
Accepted: 2019-12-16
Published Online: 2020-02-17
Published in Print: 2020-03-26

©2020 Walter de Gruyter GmbH, Berlin/Boston

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