A Randomized, Placebo-Controlled, Pilot Clinical Trial to Evaluate the Effect of Supplementation with Prebiotic Synergy 1 on Iron Homeostasis in Children and Adolescents with Celiac Disease Treated with a Gluten-Free Diet

Iron deficiency anemia (IDA) occurs in 15–46% of patients with celiac disease (CD), and in some cases, it may be its only manifestation. Studies in animal models have shown that prebiotics, including inulin, may help to increase intestinal absorption of iron. The aim of this study was to evaluate the effect of a prebiotic, oligofructose-enriched inulin (Synergy 1), on iron homeostasis in non-anemic children and adolescents with celiac disease (CD) in association with a gluten-free diet (GFD). Thirty-four CD patients (4–18 years old) were randomized into two groups receiving Synergy 1 (10 g/day) or a placebo (maltodextrin) for three months. Before and after intervention, blood samples were collected from all patients for assessment of blood morphology, biochemical parameters and serum hepcidin concentration. We found that serum hepcidin concentration after the intervention was significantly decreased by 60.9% (p = 0.046) in the Synergy 1 group, whereas no significant difference was observed in the placebo group. No differences in morphological and biochemical blood parameters (including ferritin, hemoglobin and C-reactive protein (CRP)) were observed after intervention in either group. Given that hepcidin decrease may improve intestinal iron absorption, these results warrant further investigation in a larger cohort and especially in patients with IDA.

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Faculty Opinions recommendation of Bone mineral density and importance of strict gluten-free diet in children and adolescents with celiac disease.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.5966958.5966057 ◽

2010 ◽

Author(s):

Gordon Klein

Keyword(s):

Bone Mineral Density ◽

Celiac Disease ◽

Children And Adolescents ◽

Bone Mineral ◽

Gluten Free Diet ◽

Gluten Free ◽

Mineral Density

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Bone mineral density and importance of strict gluten-free diet in children and adolescents with celiac disease

Bone ◽

10.1016/j.bone.2010.06.008 ◽

2010 ◽

Vol 47 (3) ◽

pp. 598-603 ◽

Cited By ~ 39

Author(s):

Štefan Blazina ◽

Nevenka Bratanič ◽

Andreja Širca Čampa ◽

Rok Blagus ◽

Rok Orel

Keyword(s):

Bone Mineral Density ◽

Celiac Disease ◽

Children And Adolescents ◽

Bone Mineral ◽

Gluten Free Diet ◽

Gluten Free ◽

Mineral Density

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The influence of gluten free diet on quantitative ultrasound of proximal phalanxes in children and adolescents with type 1 diabetes mellitus and celiac disease

Bone ◽

10.1016/j.bone.2008.04.004 ◽

2008 ◽

Vol 43 (2) ◽

pp. 322-326 ◽

Cited By ~ 11

Author(s):

Giuliana Valerio ◽

Raffaella Spadaro ◽

Dario Iafusco ◽

Francesca Lombardi ◽

Antonio del Puente ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Celiac Disease ◽

Type 1 Diabetes Mellitus ◽

Children And Adolescents ◽

Quantitative Ultrasound ◽

Gluten Free Diet ◽

Gluten Free

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Celiac Disease: Study of Jejunal Epithelium Before and After Gluten-Free Diet

JAMA ◽

10.1001/jama.1963.03700010145118 ◽

1963 ◽

Vol 183 (1) ◽

pp. 191

Keyword(s):

Celiac Disease ◽

Gluten Free Diet ◽

Gluten Free ◽

Before And After ◽

Disease Study

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Dermatomyositis Associated with Celiac Disease: Response to a Gluten-Free Diet

Canadian Journal of Gastroenterology ◽

10.1155/2006/574074 ◽

2006 ◽

Vol 20 (6) ◽

pp. 433-435 ◽

Cited By ~ 20

Author(s):

Min Soo Song ◽

David Farber ◽

Alain Bitton ◽

Jeremy Jass ◽

Michael Singer ◽

...

Keyword(s):

Celiac Disease ◽

Adult Population ◽

Gastrointestinal Symptoms ◽

Human Leukocyte ◽

Gluten Free Diet ◽

Nutritional Deficiencies ◽

Deficiency Anemia ◽

Gluten Free ◽

Disease Response ◽

Vitamin Deficiencies

The association between dermatomyositis and celiac disease in children has been well documented. In the adult population, however, the association has not been clearly established. A rare case of concomitant dermatomyositis and celiac disease in a 40-year-old woman is presented. After having been diagnosed with dermatomyositis and iron deficiency anemia, this patient was referred to the gastroenterology clinic to exclude a gastrointestinal malignancy. Blood tests revealed various vitamin deficiencies consistent with malabsorption. The results of gastroscopy with duodenal biopsy were consistent with celiac disease. After she was put on a strict gluten-free diet, both nutritional deficiencies and the dermatomyositis resolved. The patient’s human leukocyte antigen haplotype study was positive for DR3 and DQ2, which have been shown to be associated with both juvenile dermatomyositis and celiac disease. It is suggested that patients with newly diagnosed dermatomyositis be investigated for concomitant celiac disease even in the absence of gastrointestinal symptoms.

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NUTRITIONAL STATUS AND MICRONUTRIENT LEVELS OF CHILDREN WITH CELIAC DISEASE BEFORE AND AFTER GLUTEN FREE DIET

The Professional Medical Journal ◽

10.29309/tpmj/2006.13.01.5075 ◽

2006 ◽

Vol 13 (01) ◽

pp. 145-150

Author(s):

HINA AYESHA ◽

Muhammed Asghar Butt ◽

MUHAMMED SHAMOON ◽

Maqbool Ahmed ◽

BUSHRA NAZIR ◽

...

Keyword(s):

Celiac Disease ◽

Nutritional Status ◽

Serum Zinc ◽

Gluten Free Diet ◽

Control Group ◽

Inflammatory Disorder ◽

Healthy Children ◽

Gluten Free ◽

Trace Mineral ◽

Before And After

Introduction: Celiac disease is an autoimmune inflammatory disorder ofsmall intestine precipitated by ingestion of gluten. Clinical and histological improvement occurs on withdrawal of glutenfrom the diet. Objectives: The present study were to identify the trace mineral deficiency in newly diagnosed celiacchildren and to assess how far these deficiencies are corrected after strict gluten free diet. The study also assessedthe nutritional status of celiac children compared to the healthy controls before and after Gluten Free Diet. Setting:Department of Pediatrics Punjab Medical College Faisalabad. Duration: January 2004 to March 2005. Study Design:Interventional case control study. Patients and Methods: 22 children aged 2 to 14 years diagnosed as Celiac diseaseon the basis of typical intestinal biopsy findings were included. 15 healthy children served as controls. Anthropometricmeasurements and serum Zinc Copper Magnesium and Iron along with albumin were done for both patients andcontrols initially and repeated after 6 months while patients were receiving strict GFD and controls receiving normaldiet. The general linear model was used for the analysis of variance using SPSS (2004). Results: Serum Zinc wasbelow the reference range in 68%. Serum copper and Magnesium in 31%, Iron in 95%and albumin in 59% of thepatients. There was a statistically significant increase in serum zinc, iron and magnesium levels (p value, < 0 05) whileserum copper and albumin did not show any significant rise after Gluten free diet. Control group did not show any significant change in their trace mineral levels .Celiac patients gained more weight (mean 4.47 versus 2.91 cm) andheight (3.34cm versus 1.022 cm) as compared to the control group. Conclusion: Celiac children receiving strict Glutenfree diet and showing good clinical response probably do not need mineral supplementation.

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