Affiliation:
1. Division of Pediatric Gastroenterology, Children's Specialized Hospital King Fahad Medical City Riyadh Saudi Arabia
2. College of Medicine Alfaisal University
3. Department of Pediatrics, Faculty of Medicine, Prince Abdullah bin Khalid Celiac Disease Research Chair King Saud University
4. Department of Medical Translational Sciences & European Laboratory for the Investigation of Food‐Induced Diseases University Federico II Naples Italy
5. Department of Nutrition King Fahad Medical City Riyadh Saudi Arabia
6. Department of Biostatistics, Research Services Adminsitration, Research Center King Fahad Medical City Riyadh Riyadh Saudi Arabia
Abstract
AbstractObjectivesMicronutrient deficiencies characterize classical “late‐diagnosed” celiac disease (CeD). This study aimed to identify the prevalence of micronutrient deficiencies among children with “early‐diagnosed” screening‐identified CeD to determine the clinical value of routine testing for deficiencies in those patients.MethodsA case‐control study was conducted on screening‐identified CeD patients diagnosed during a mass screening study (84 patients, mean age 11.3 ± 2.6 years). The controls (443 children, mean age 10.8 ± 2.5 years) were negative for celiac disease serological screening. Hemoglobin, serum levels of iron, ferritin, folate, vitamin B12, vitamin A, vitamin E, 25‐OH vitamin D, zinc, and selenium were measured.ResultsThe mean serum levels of hemoglobin, iron, ferritin, vitamin D, zinc, copper, and selenium were significantly lower in CeD patients than in healthy controls (hemoglobin 12.56 vs. 13.02 g/dL [p = 0.04]; iron 10.61 vs. 17.6 µmol/L [p < 0.001], ferritin 25.7 vs. 48.3 µg/L [p < 0.001], vitamin D 29.1 vs. 37.5 nmol/L, zinc 11.9 vs. 21.7 µmol/L, copper 18.9 vs. 32.5 µmol/L, selenium 1.04 vs. 1.36 µmol/L; p < 0.001). Patients with celiac and severe intestinal damage (Marsh IIIb and IIIc) had significantly lower serum ferritin and vitamin A levels than patients with mild intestinal damage (Marsh II and IIIa) (ferritin 15 vs. 22 µg/L, p < 0.025; vitamin A 0.85 vs. 1.35 µmol/L, p = 0.007).ConclusionMicronutrient deficiencies are still detectable in “early‐diagnosed” screening‐identified CeD cases, a clinically relevant result that strongly supports efforts for screening and early diagnosis of CeD.