Shahraki Touran, Shahraki Mansour, Hill Ivor D
Department of Pediatrics, Faculty of Medicine, Children and Adolescents Health Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Science's, Zahedan, Iran.
Department of Nutrition, Children and Adolescents Health Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Science's, Zahedan, Iran.
Prz Gastroenterol. 2018;13(2):127-131. doi: 10.5114/pg.2018.73347. Epub 2018 Feb 7.
A small number of overweight and obese children with celiac disease (CD) has been reported.
To estimate the prevalence of obesity, underweight and normal weight in a group of Iranian pediatric patients.
In a retrospective study from 2007 to 2015, 225 children less than 18 years old with biopsy-proven CD were enrolled. Data collected included demographic characteristics, clinical presentation, antibody titers and severity of small-bowel mucosal damage. Body mass index (BMI) profile of subjects was calculated based on the age and gender percentile at presentation.
The mean ± standard deviation (SD) for age was 7.4 ±3.8 and 62% of patients were female. Fifty-four percent of patients presented with a normal BMI, 43% were underweight, and the remaining patients (3.5%) were overweight/obese. The mean age of underweight and normal weight patients was higher than that of obese/overweight patients. Mean ± SD of TTG titer was higher in overweight/obese and normal weight children compared to underweight subjects. The majority of patients (195/225) had severe enteropathy compatible with Marsh III on duodenal biopsy. Most of the children had gastrointestinal (GI) and extra-intestinal manifestations on presentation. There was no association between severity of histological disease and BMI for age. Five out of eight cases in the obese/overweight group had an index case with CD in their family.
This study highlights the importance of considering celiac disease in children regardless of their BMI. Failure to diagnose CD in children leads to unnecessary diagnostic delays and long-term adverse health consequences.
据报道，患有乳糜泻（CD）的超重和肥胖儿童数量较少。
评估一组伊朗儿科患者中肥胖、体重过轻和正常体重的患病率。
在一项2007年至2015年的回顾性研究中，纳入了225名18岁以下经活检证实患有CD的儿童。收集的数据包括人口统计学特征、临床表现、抗体滴度和小肠黏膜损伤的严重程度。根据就诊时的年龄和性别百分位数计算受试者的体重指数（BMI）。
年龄的平均值±标准差（SD）为7.4±3.8，62%的患者为女性。54%的患者BMI正常，43%体重过轻，其余患者（3.5%）超重/肥胖。体重过轻和正常体重患者的平均年龄高于肥胖/超重患者。与体重过轻的受试者相比，超重/肥胖和正常体重儿童的TTG滴度平均值±SD更高。大多数患者（195/225）在十二指肠活检中患有与马什III型相符的严重肠病。大多数儿童在就诊时出现胃肠道（GI）和肠外表现。组织学疾病的严重程度与年龄BMI之间无关联。肥胖/超重组的八例中有五例其家族中有CD索引病例。
本研究强调了无论BMI如何，都应考虑儿童乳糜泻的重要性。未能诊断儿童CD会导致不必要的诊断延迟和长期不良健康后果。
