Altered Duodenal Microbiota Composition in Celiac Disease Patients Suffering From Persistent Symptoms on a Long-Term Gluten-Free Diet

The assessment of compliance of gluten-free diet (GFD) is a keystone in the supervision of celiac disease (CD) patients. Few data are available documenting evidence-based follow-up frequency for CD patients. In this work we aim at creating a criterion for timing of clinical follow-up for CD patients using data mining. We have applied data mining to a dataset with 188 CD patients on GFD (75% of them are children below 14 years old), evaluating the presence of gluten immunogenic peptides (GIP) in stools as an adherence to diet marker. The variables considered are gender, age, years following GFD and adherence to the GFD by fecal GIP. The results identify patients on GFD for more than two years (41.5% of the patients) as more prone to poor compliance and so needing more frequent follow-up than patients with less than 2 years on GFD. This is against the usual clinical practice of following less patients on long term GFD, as they are supposed to perform better. Our results support different timing follow-up frequency taking into consideration the number of years on GFD, age and gender. Patients on long term GFD should have a more frequent monitoring as they show a higher level of gluten exposure. A gender perspective should also be considered as non-compliance is partially linked to gender in our results: Males tend to get more gluten exposure, at least in the cultural context where our study was carried out. Children tend to perform better than teenagers or adults.

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A Phase I Study to Determine Safety, Tolerability and Bioactivity of Nexvax2® in HLA DQ2+ Volunteers With Celiac Disease Following a Long-Term, Strict Gluten-Free Diet

Gastroenterology ◽

10.1016/s0016-5085(11)61794-0 ◽

2011 ◽

Vol 140 (5) ◽

pp. S-437-S-438 ◽

Cited By ~ 23

Author(s):

Gregor J. Brown ◽

James Daveson ◽

Joanne K. Marjason ◽

Rose A. Ffrench ◽

Danielle Smith ◽

...

Keyword(s):

Celiac Disease ◽

Phase I ◽

Phase I Study ◽

Gluten Free Diet ◽

Gluten Free ◽

Hla Dq2

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A23 NUTRITIONAL DEFICIENCIES ARE FREQUENT IN CELIAC PATIENTS ON A GLUTEN-FREE DIET, REGARDLESS OF THE DURATION AND COMPLIANCE OF THE DIET

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz047.022 ◽

2020 ◽

Vol 3 (Supplement_1) ◽

pp. 27-28

Author(s):

A Jivraj ◽

V Connan ◽

T Balart ◽

E Ching ◽

A Marwaha ◽

...

Keyword(s):

Tissue Transglutaminase ◽

Gluten Free Diet ◽

Nutritional Deficiencies ◽

Gluten Free ◽

Dietary Compliance ◽

Persistent Symptoms ◽

Funding Agencies ◽

Adherence Test

Abstract Background The only available treatment for celiac disease (CD) is adherence to a strict gluten-free diet (GFD). CD is associated with several nutritional deficiencies, which could be explained by malabsorption when the disease is active. However, the magnitude of nutritional deficiencies in treated CD and how this is influenced by the duration and compliance of GFD is less clear. Aims We aim to evaluate the presence of nutritional deficiencies in celiac patients on short term (≤2yrs) vs long-term (>2yrs) GFD, and in those with persistent symptoms or asymptomatic in the follow up. Methods We included consecutive biopsy-proven CD patients attending the McMaster Adult Celiac Clinic. GFD adherence was assessed by validated Celiac Dietary Adherence Test (CDAT) and by anti-tissue transglutaminase antibody IgA(tTG IgA) levels. Serology, vitamins and minerals were measured in blood samples collected at enrolment. Continuous data was expressed as Median (IQR) and categorical data as proportion%. Mann-U-Whitney and Chi2 were used to compare difference between groups. Results We enrolled 171 CD patients (80% female; Median age 43 years). 76/171 (44%) of CD patients were following a GFD for over 2 years. Eighty-two percent of the patients (141/171) had persistent symptoms in the follow up and 80.7% had normal tTG IgA levels. The most common nutritional abnormalities were deficiencies in zinc (56%), iron (23%), copper (20%). Chromium was increased in 74% of patients. There were no differences in nutritional deficiencies between group of patients with short and long-term duration of GFD, nor between those strictly compliant with GFD compared to those fairly compliant (p>0.05). Conclusions Nutritional deficiencies are frequent in celiac patients on a GFD regardless of the presence of symptoms, dietary compliance or duration. The previous suggest that nutrients deficiencies may be more related to GFD nutritional inadequacy rather than malabsorption. Funding Agencies None

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