Incidence of malnutrition in people with celiac disease in Ecuador. A diagnostic study
DOI:
https://doi.org/10.56294/saludcyt20251280Keywords:
diagnosis, underweight, diet, malabsorption, micronutrientsAbstract
Celiac disease (CD) is an enteropathy caused by an autoimmune disorder triggered by gluten exposure in genetically susceptible individuals. In CD patients, autoantibodies attack proteins in the intestinal tissues and create damage to the intestinal villi resulting in malabsorption of nutrients and maldigestion. Undiagnosed and untreated CD can lead to severe malabsorption and malnutrition. A diagnostic epidemiological study was conducted to evaluate the incidence of malnutrition in adults and children with CD in Ecuador. In total, 35 CD patients were eligible and body mass index (BMI) was determined. The study cohort was separated into 3 age groups and BMI was compared with indicators of undernutrition reported in the National Health and Nutrition Survey of Ecuador. The participants in the study were interviewed to determine the degree of information and awareness of the importance of the gluten-free diet for their health status. We detected an increased trend in the incidence of malnutrition in celiac disease patients at pediatric ages, and increased awareness of the importance of the gluten-free diet in adults. Nutritional evaluation of CD patients is essential in pediatric ages to achieve a more effective management of these patients and to avoid the consequences of malnutrition in early stages of life.
References
1. Therrien A, Kelly CP, Silvester JA. Celiac Disease: Extraintestinal Manifestations and Associated Conditions. Journal of Clinical Gastroenterology 2020;54(1):8–21; doi: 10.1097/MCG.0000000000001267.
2. De La Calle I, Ros G, Peñalver Miras R, et al. Celiac disease: causes, pathology, and nutritional assessment of gluten-free diet. A review. Nutr Hosp 2020; doi: 10.20960/nh.02913.
3. Lebwohl B, Rubio-Tapia A. Epidemiology, Presentation, and Diagnosis of Celiac Disease. Gastroenterology 2021;160(1):63–75; doi: 10.1053/j.gastro.2020.06.098.
4. Ramírez-Sánchez AD, Tan IL, Gonera-de Jong BC, et al. Molecular Biomarkers for Celiac Disease: Past, Present and Future. IJMS 2020;21(22):8528; doi: 10.3390/ijms21228528.
5. Malamut G, Soderquist CR, Bhagat G, et al. Advances in Nonresponsive and Refractory Celiac Disease. Gastroenterology 2024;S0016508524003603; doi: 10.1053/j.gastro.2024.02.048.
6. Al-Toma A, Volta U, Auricchio R, et al. European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterol J 2019;7(5):583–613; doi: 10.1177/2050640619844125.
7. Setavand Z, Ekramzadeh M, Honar N. Evaluation of malnutrition status and clinical indications in children with celiac disease: a cross-sectional study. BMC Pediatr 2021;21(1):147; doi: 10.1186/s12887-021-02621-3.
8. See JA, Kaukinen K, Makharia GK, et al. Practical insights into gluten-free diets. Nat Rev Gastroenterol Hepatol 2015;12(10):580–591; doi: 10.1038/nrgastro.2015.156.
9. Wieser H, Ruiz-Carnicer Á, Segura V, et al. Challenges of Monitoring the Gluten-Free Diet Adherence in the Management and Follow-Up of Patients with Celiac Disease. Nutrients 2021;13(7):2274; doi: 10.3390/nu13072274.
10. Ludvigsson JF, Murray JA. Epidemiology of Celiac Disease. Gastroenterology Clinics of North America 2019;48(1):1–18; doi: 10.1016/j.gtc.2018.09.004.
11. Pittschieler K, Reissigl H, Mengarda G. Celiac disease in two different population groups of South Tirol. J Pediatr Gastroenterol Nutr 1988;7(3):400–402; doi: 10.1097/00005176-198805000-00014.
12. Anonymous. Influence of Mediterranean Diet Adherence and Physical Activity on Bone Health in Celiac Children on a Gluten-Free Diet - PubMed. n.d. Available from: https://pubmed.ncbi.nlm.nih.gov/34068001/ [Last accessed: 9/26/2024].
13. Anonymous. WHO Child Growth Standards: Growth Velocity Based on Weight, Length and Head Circumference: Methods and Development. n.d. Available from: https://www.who.int/publications/i/item/9789241547635 [Last accessed: 9/24/2024].
14. Mather LE, Austin KL. The Statistical Package for the Social Sciences (SPSS) as an adjunct to pharmacokinetic analysis. Biopharm Drug Dispos 1983;4(2):157–172; doi: 10.1002/bdd.2510040208.
15. Cando F, Martínez, Diego, Pozo, Monica. Antropometria. In: Reportes de La ENSANUT 2018. Instituto Nacional de Estadística y Censos; n.d.
16. Mędza A, Szlagatys-Sidorkiewicz A. Nutritional Status and Metabolism in Celiac Disease: Narrative Review. J Clin Med 2023;12(15):5107; doi: 10.3390/jcm12155107.
17. Hung M, Blazejewski A, Lee S, et al. Nutritional Deficiencies and Associated Oral Health in Adolescents: A Comprehensive Scoping Review. Children (Basel) 2024;11(7):869; doi: 10.3390/children11070869.
18. Setavand Z, Ekramzadeh M, Honar N. Evaluation of malnutrition status and clinical indications in children with celiac disease: a cross-sectional study. BMC Pediatr 2021;21:147; doi: 10.1186/s12887-021-02621-3.
19. Almallouhi E, King KS, Patel B, et al. Increasing Incidence and Altered Presentation in a Population-based Study of Pediatric Celiac Disease in North America. J Pediatr Gastroenterol Nutr 2017;65(4):432–437; doi: 10.1097/MPG.0000000000001532.
20. Marino M, Galeazzi T, Gesuita R, et al. Differences in Plasma 25-Hydroxyvitamin D Levels at Diagnosis of Celiac Disease and Type 1 Diabetes. Nutrients 2024;16(5):743; doi: 10.3390/nu16050743.
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Copyright (c) 2025 Verónica Alexandra Robayo Zurita, Kattyta Patricia Hidalgo Morales, Carmen Patricia Viteri Robayo, Cristina Alexandra Arteaga Almeida, Deysi Guevara (Author)
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