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Vitamin B-6 absorption in children with acute celiac disease and in control subjects
Insights
Children with celiac disease show biochemical vitamin B-6 deficiency, indicated by reduced serum pyridoxal phosphate levels after a pyridoxine load test. This suggests impaired pyridoxine absorption in celiac disease.
Area of Science:
- Biochemistry
- Pediatric Gastroenterology
- Nutritional Science
Background:
- Celiac disease is an autoimmune disorder affecting the small intestine.
- Vitamin B-6 deficiency, specifically low serum pyridoxal phosphate, is a known complication in celiac disease.
- Understanding the absorption dynamics of vitamin B-6 is crucial for managing nutritional deficiencies in affected children.
Purpose of the Study:
- To investigate vitamin B-6 metabolism in children with acute celiac disease.
- To compare serum pyridoxal phosphate levels after oral pyridoxine loading in celiac patients versus healthy controls.
- To explore the relationship between pyridoxine absorption and xylose absorption in celiac disease.
Main Methods:
- Oral pyridoxine hydrochloride loading test (5 mg/kg body weight).
- Measurement of serum pyridoxal phosphate concentrations at baseline and various time points (15, 30, 60, 90, 120 minutes).
- Assessment of blood xylose levels following oral loading.
Main Results:
- Children with acute celiac disease exhibited significantly lower serum pyridoxal phosphate increases post-loading compared to controls.
- Peak serum pyridoxal phosphate levels were delayed (60 min) and lower in celiac patients versus controls (30 min).
- A positive correlation was observed between pyridoxal phosphate increase and blood xylose increase, suggesting malabsorption.
Conclusions:
- Children with acute celiac disease present with biochemical vitamin B-6 deficiency.
- Impaired pyridoxine absorption, potentially due to altered intestinal absorption sites, is indicated in childhood celiac disease.
- Results suggest pyridoxine malabsorption and a shift in absorption from the upper jejunum to distal intestine in celiac disease.
Abstract:
The concentration of serum pyridoxal phosphate was determined before and 15, 30, 60, 90, and 120 minutes following an oral load test with 5 mg pyridoxine hydrochloride/kg body weight in 14 children with acute celiac disease and in 15 control subjects. Children with acute celiac disease suffer from a biochemical vitamin B-6 deficiency. The increase in pyridoxal phosphate of children with acute celiac disease after loading was significantly decreased when compared with that of control subjects. In children with celiac disease maximal concentration of serum pyridoxal phosphate appeared later (after 60 minutes) and was decreased in comparison to control subjects (after 30 minutes). A positive correlation existed between the net increase of pyridoxal phosphate 60 minutes following pyridoxine loading and the net increase of blood xylose 60 minutes after oral loading. The results are compatible both with a malabsorption of pyridoxine in childhood celiac disease and a shifting of the site of pyridoxine absorption from the upper part of jejunum into the more distal parts of intestine.