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Growth patterns in coeliac disease - a longitudinal study of children aged 0-6 years in Sweden
Lisa Andersson Fjelstad1, Annelie Lindholm1, Julia S Malmborg1
1School of Health and Welfare, Halmstad University, Halmstad, Sweden.
Insights
Children with coeliac disease (CD) often show growth deviations, most prominent near diagnosis. Monitoring growth may help detect CD earlier in children, with significant improvement post-treatment.
Area of Science:
- Pediatric Endocrinology
- Gastroenterology
- Child Health
Background:
- Growth deviations are linked to coeliac disease (CD) in children.
- Limited longitudinal data exists on when these growth issues first appear.
- This study examines growth patterns in relation to CD diagnosis timing in Swedish preschoolers.
Purpose of the Study:
- To investigate the occurrence and timing of growth deviations before and after coeliac disease diagnosis.
- To assess if growth deviation patterns differ between boys and girls.
- To understand the clinical implications of growth monitoring for early CD detection.
Main Methods:
- Retrospective longitudinal study of 185 children diagnosed with CD.
- Analysis of background characteristics and growth deviations relative to CD diagnosis.
- Statistical tests including chi-square, Mann-Whitney U, ANOVA, Kruskal-Wallis, paired t-tests, and Wilcoxon signed rank tests were used.
Main Results:
- Growth deviations were most pronounced around the time of CD diagnosis (mean weight SDS -0.54, height SDS -0.48).
- Children diagnosed between 36-48 months showed greater height deviations prior to diagnosis compared to younger children.
- Significant improvements in weight and height SDS were observed within two years after diagnosis and treatment initiation.
Conclusions:
- Growth deviations in children with CD vary by age at diagnosis, peaking near diagnosis.
- Growth significantly improves post-diagnosis and treatment.
- Subtle growth deviations may precede CD diagnosis, highlighting the importance of growth monitoring in pediatric care.
Background:
Associations between growth deviations and coeliac disease (CD) in children have been documented, but longitudinal evidence-particularly concerning when such deviations first emerge-is limited. The aim of this study was to investigate the occurrence and timing of growth deviations in relation to CD diagnosis, and to assess whether these patterns differed between boys and girls in a Swedish preschool population.
Methods:
This retrospective longitudinal study was conducted as part of the project Evidence based knowledge about deviant growth in children 0-6 years. A total of 185 children with CD were identified through the Regional Healthcare Information Platform. Background characteristics and growth deviations relative to the time of CD diagnosis were analysed using descriptive statistics and tests, including chi square, Mann-Whitney U, one way ANOVA, Kruskal-Wallis, paired t tests, and Wilcoxon signed rank tests.
Results:
Of the 185 participating children, 64 (34.6%) were boys and 121 (65.4%) were girls. Growth deviations were most pronounced at the time of diagnosis, with mean weight SDS of - 0.54 (± 1.2) and mean height SDS of - 0.48 (± 1.1). No significant sex differences were observed. Children diagnosed between 36 and 48 months exhibited significantly greater negative height SDS deviations at one year and six months prior to diagnosis compared with younger age groups. Significant improvements in both weight SDS and height SDS were observed during the two years following diagnosis and initiation of treatment.
Conclusion:
Growth deviations varied according to age at CD diagnosis, with the most pronounced deviations occurring in proximity to the diagnostic timepoint. Growth improved significantly during the two years following diagnosis. These findings suggest that subtle growth deviations may be detectable years before diagnosis, supporting the clinical value of careful growth monitoring in paediatric care. Further research on the implementation of growth based screening parameters in routine practice is warranted.
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