COMPLY-CATeD: Celiac Adherence in Teens Diagnosed: an Italian multicentric study

Area of Science:

• Gastroenterology
• Pediatric Gastroenterology
• Clinical Nutrition

Background:

• The gluten-free diet (GFD) is the only effective treatment for coeliac disease (CeD).
• Evaluating GFD adherence is crucial for CeD management, especially in adolescents.
• Limited data exists on GFD adherence in pediatric CeD patients based on diagnostic method (biopsy vs. biopsy-sparing).

Purpose of the Study:

• To investigate and compare GFD adherence in adolescents with CeD based on their diagnostic method.
• To assess adherence using validated tools like the Celiac Dietary Adherence Test (CDAT) and Biagi score.
• To explore the validation of an evaluation tool for GFD compliance in this specific population.

Main Methods:

• A multicentric study included 206 adolescents (14-18 years) diagnosed with CeD between 2012-2019 and on GFD for at least 2 years.
• Dietary adherence was evaluated using the Leffler questionnaire (CDAT) and the Biagi score.
• Patients were categorized based on diagnosis via biopsy confirmation versus the biopsy-sparing approach.

Main Results:

• No significant difference in Biagi scores was found between the biopsy and biopsy-sparing diagnostic groups (P=0.057).
• Poor or suboptimal adherence (CDAT score ≥13) was observed in 66 patients diagnosed by biopsy and 12 by the biopsy-sparing method (P=0.362).
• Multivariate analysis showed no statistical significance for diagnostic method, age at diagnosis, or education level on CDAT scores (P=0.1, R²=0.031).

Conclusions:

• Adherence to a gluten-free diet in adolescents with CeD is comparable between those diagnosed via biopsy and those diagnosed using the biopsy-sparing approach.
• The diagnostic method does not appear to influence GFD adherence in this adolescent population.
• Age at diagnosis and educational level also did not significantly impact adherence scores in the studied cohort.