Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Faculty of Medicine, İnönü University, Malatya, Turkey.
Eur J Gastroenterol Hepatol. 2013 Oct;25(10):1206-11. doi: 10.1097/MEG.0b013e3283638534.
Growth retardation is one of the most important signs of childhood celiac disease (CD); however, it is not very well known whether craniofacial growth is also affected. We aimed to carry out a detailed craniofacial morphological study to derive a conclusion on the craniofacial features of children with CD.
Eighty-four 2-16-year-old children with biopsy-proven CD and 84 age-matched and sex-matched healthy children were included. Of these, 37 children (44.0%) had been newly diagnosed and 47 (56.0%) were on a gluten-free diet. Anteroposterior and lateral photographs were evaluated using the Scion Image software program for the measurements of the distances between reference points on the face.
Except for nasofrontal angle (nfa), nasolabial angle (nla), pronasale height (prnh), nasal dorsum height (ndh), and nasal radix height (nrh), all measurements were significantly greater in patients compared with controls. In celiac children, all facial proportions except forehead/face height (t-gl/t-gn) and nose length/face height (n-ns/t-gn) were significantly different from those of controls. Except for nla, prnh, ndh, nrh, t-gl/t-gn, face height to total face height ratio (sn-gn/t-gn), n-sn/t-gn, ear length to face height ratio (s-sba/t-gn), and face width to face height ratio (z-z/t-gn), all measurements were statistically different in those on a gluten-free diet and newly diagnosed children.
Most of the facial measurements and proportions of celiac children were different from those of controls. Our data confirm those of a previous study reporting that the forehead proportion is not altered in childhood CD. Pathophysiological mechanisms underlying these alterations are not clear but disruptions of growth during certain critical periods may be responsible.
生长迟缓是儿童乳糜泻（CD）最重要的体征之一，但颅面生长是否受到影响尚未被广泛认知。本研究旨在进行详细的颅面形态学研究，以明确 CD 患儿的颅面特征。
共纳入 84 名经活检证实的 CD 患儿和 84 名年龄和性别匹配的健康儿童。其中 37 名患儿（44.0%）为初诊，47 名患儿（56.0%）接受无麸质饮食治疗。使用 Scion Image 软件程序评估前后位和侧位照片，以测量面部参考点之间的距离。
除鼻额角（nfa）、鼻唇角（nla）、前鼻棘高度（prnh）、鼻背高度（ndh）和鼻根高度（nrh）外，患者的所有测量值均显著大于对照组。在乳糜泻患儿中，除额面高（t-gl/t-gn）和鼻长面高（n-ns/t-gn）外，所有面部比例均与对照组存在显著差异。除 nla、prnh、ndh、nrh、t-gl/t-gn、面高占总面高比值（sn-gn/t-gn）、n-sn/t-gn、耳长面高比值（s-sba/t-gn）和面宽面高比值（z-z/t-gn）外，无麸质饮食组和初诊组的所有测量值均存在统计学差异。
乳糜泻患儿的大部分面部测量值和比例与对照组存在差异。本研究数据证实了先前的研究报告，即儿童 CD 时前额比例并未改变。这些改变的病理生理机制尚不清楚，但在某些关键时期生长中断可能是其原因。
