Atherosclerotic Risk Factors in Children with Celiac Disease

Area of Science:

• Pediatric Gastroenterology
• Nutritional Science
• Cardiovascular Risk Assessment

Background:

• Celiac disease (CD) requires a strict gluten-free diet (GFD).
• Long-term metabolic and cardiovascular effects of GFD in children are not fully understood.
• Altered nutritional status and lifestyle factors may impact cardiovascular health in pediatric CD.

Purpose of the Study:

• To investigate the lipid profile, folic acid levels, body mass index (BMI), physical activity, and sleep duration in children with CD on a GFD.
• To explore potential correlations between these factors and cardiovascular risk markers.
• To identify potential long-term health risks associated with managing CD in children.

Main Methods:

• Cross-sectional analysis of children diagnosed with celiac disease.
• Biochemical measurements including total cholesterol, LDL-C, HDL, apolipoproteins A1 and B, hCRP, and folic acid levels.
• Assessment of z-score BMI, physical activity, and sleep duration.

Main Results:

• Children with CD exhibited lower total cholesterol, LDL-C, apolipoproteins A1 and B, and hCRP.
• A significant decrease in folic acid levels was observed, particularly in those on GFD for over 5 years or after 1 year of GFD.
• Negative correlations were found between BMI z-score and HDL/APOA1, and positive correlations with atherogenic lipid ratios. Insulin levels increased with inactivity, and sleep duration correlated positively with adiponectin.

Conclusions:

• GFD in children with CD is associated with decreased folic acid, elevated BMI, sedentary behavior, and unfavorable lipid profiles.
• These factors may collectively increase the long-term risk of atherosclerosis in this pediatric population.
• Further research is warranted to establish the need for metabolic and cardiovascular risk screening in children with CD.