NUTRITIONAL STATUS AND MICRONUTRIENT LEVELS OF CHILDREN WITH CELIAC DISEASE BEFORE AND AFTER GLUTEN FREE DIET

Abstract

Introduction: Celiac disease is an autoimmune inflammatory disorder of
small intestine precipitated by ingestion of gluten. Clinical and histological improvement occurs on withdrawal of gluten
from the diet. Objectives: The present study were to identify the trace mineral deficiency in newly diagnosed celiac
children and to assess how far these deficiencies are corrected after strict gluten free diet. The study also assessed
the nutritional status of celiac children compared to the healthy controls before and after Gluten Free Diet. Setting:
Department of Pediatrics Punjab Medical College Faisalabad. Duration: January 2004 to March 2005. Study Design:
Interventional case control study. Patients and Methods: 22 children aged 2 to 14 years diagnosed as Celiac disease
on the basis of typical intestinal biopsy findings were included. 15 healthy children served as controls. Anthropometric
measurements and serum Zinc Copper Magnesium and Iron along with albumin were done for both patients and
controls initially and repeated after 6 months while patients were receiving strict GFD and controls receiving normal
diet. The general linear model was used for the analysis of variance using SPSS (2004). Results: Serum Zinc was
below the reference range in 68%. Serum copper and Magnesium in 31%, Iron in 95%and albumin in 59% of the
patients. There was a statistically significant increase in serum zinc, iron and magnesium levels (p value, < 0 05) while
serum copper and albumin did not show any significant rise after Gluten free diet. Control group did not show any significant change in their trace mineral levels .Celiac patients gained more weight (mean 4.47 versus 2.91 cm) and
height (3.34cm versus 1.022 cm) as compared to the control group. Conclusion: Celiac children receiving strict Gluten
free diet and showing good clinical response probably do not need mineral supplementation.