The Effect of Gluten-free Diet on Cardiovascular Risk Factors in Newly Diagnosed Pediatric Celiac Disease Patients

J Pediatr Gastroenterol Nutr. 2019 May;68(5):684-688. doi: 10.1097/MPG.0000000000002235.

Abstract

Objectives: Although gluten-free diet (GFD) is the only proven therapy for celiac disease (CD), its effect on cardiovascular disease (CVD) risk factors is still unclear. Our aim was to determine whether adherence to GFD affects CVD risk factors among newly diagnosed pediatric CD subjects.

Methods: We prospectively enrolled pediatric subjects undergoing upper gastrointestinal endoscopy for suspected CD. We collected anthropometric and laboratory parameters related to CVD risk factors at the time of CD diagnosis and 1 year after initiation of a GFD and evaluated changes in CVD risk factors. Paired t tests or Wilcoxon nonparametric tests were used, each when appropriate.

Results: One hundred ten newly diagnosed CD pediatric subjects were included in the analysis. There were 64 (58.2%) girls and the mean age at diagnosis was 6.8 ± 3.4 years. Median body mass index z scores (P = 0.84), rates of underweight or overweight (P = 0.32), and rates of elevated blood pressure (P = 0.78) remained unchanged. Although median fasting insulin levels increased (1.9 vs 5.4 μU/mL, P < 0.001), insulin resistance as measured by homeostatic model assessment did not increase after 1 year of GFD (P = 0.16). Although rates of dyslipidemia remained unchanged, median high-density lipoprotein levels increased on GFD (47 vs 51 mg/dL, P < 0.001).

Conclusions: In this pediatric CD cohort, GFD for 1 year was not associated with increased CVD risk factors. The long-term significance of these mild changes is yet to be determined.

Publication types

  • Evaluation Study

MeSH terms

  • Anthropometry
  • Body Mass Index
  • Cardiovascular Diseases / etiology*
  • Celiac Disease / complications
  • Celiac Disease / diet therapy
  • Celiac Disease / physiopathology*
  • Child
  • Child, Preschool
  • Diet, Gluten-Free / adverse effects*
  • Female
  • Humans
  • Insulin Resistance
  • Male
  • Prospective Studies
  • Risk Factors
  • Treatment Outcome