Obesity in pediatric celiac disease

Area of Science:

• Pediatric Gastroenterology
• Autoimmune Diseases
• Nutritional Science

Background:

• Celiac disease (CD) is an autoimmune enteropathy triggered by gluten in genetically susceptible individuals.
• While often associated with malabsorption, CD can present atypically in obese children.
• Screening high-risk groups, including those with diabetes, increases CD diagnosis in obese pediatric populations.

Purpose of the Study:

• To determine the prevalence of obesity at diagnosis in pediatric celiac disease patients.
• To characterize the clinical presentation of obese children with celiac disease.

Main Methods:

• Retrospective analysis of 143 pediatric celiac disease patients diagnosed between 1986 and 2003.
• Data collected included demographics, symptoms, BMI, antibody titers, biopsy results, and weight changes after gluten-free diet (GFD).

Main Results:

• 5% of pediatric CD patients (7/143) were obese (BMI >95th percentile).
• Obese children commonly presented with abdominal pain, diabetes, and diarrhea.
• Gluten-free diet improved symptoms; BMI changes varied post-treatment.

Conclusions:

• Obesity is a more frequent comorbidity in pediatric celiac disease than previously recognized.
• Celiac disease should be considered in the differential diagnosis of obese children, particularly those with suggestive symptoms.