Pediatric Gastroenterology Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Pediatric Endocrinology Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Pediatr Res. 2023 Aug;94(2):618-625. doi: 10.1038/s41390-023-02496-3. Epub 2023 Jan 27.
Celiac disease (CD) in children and adolescents has been linked with increased susceptibility for cardiometabolic disease in adulthood. We explored the interaction between body composition and metabolic syndrome (MetS) components in pediatric CD.
We conducted a retrospective observational study of patients with CD followed at our Pediatric Endocrine and Gastroenterology Units between 1/2018-1/2022. Data on sociodemographic, clinical, laboratory, and body composition parameters (bioelectrical impedance analysis, BIA) were collected.
Forty-four patients with MetS components and 67 patients without them were enrolled. The cohort's mean age at BIA assessment was 11.5 ± 3.6 years. Individuals with MetS components were older (P = 0.045), had higher BMI z-scores (P < 0.001), higher total and truncal fat percentage levels (P < 0.001), lower muscle-to-fat ratio z-scores (P = 0.018), higher sarcopenic indices (P = 0.05), higher systolic blood pressure percentiles (P = 0.001), higher triglycerides levels (P = 0.009), and higher triglycerides/HDL-c ratios (P < 0.001) than those without MetS components. A sex- and age-adjusted model revealed that the diagnosis of MetS components was positively associated with fat percentage (odds ratio = 1.087, confidence interval [1.010-1.171], P = 0.027), but not with BMI z-scores (P = 0.138).
We found that fat percentage but not weight status is associated with risk for MetS components in individuals with childhood-onset CD. Preventive interventions should target an improvement in body composition.
The literature on cardiometabolic risk in pediatric patients with celiac disease (CD) is sparse. Our analysis revealed that at least one metabolic syndrome (MetS) component was present in two out of every five children and adolescents with CD. An increase in fat percentage but not in body mass index z-scores predicted the presence of MetS components in our cohort. These findings suggest that the weight status of children and adolescents with CD does not mirror their risk for MetS components. Body composition analysis should be considered as an integral part of the clinical evaluation in young patients with CD.
儿童和青少年时期的乳糜泻与成年后患心血管代谢疾病的易感性增加有关。我们探讨了儿科乳糜泻患者的身体成分与代谢综合征（MetS）成分之间的相互作用。
我们对在我们的儿科内分泌和胃肠病学单位就诊的乳糜泻患者进行了回顾性观察性研究，随访时间为 2018 年 1 月至 2022 年 1 月。收集了社会人口统计学、临床、实验室和身体成分参数（生物电阻抗分析，BIA）的数据。
共有 44 名患者有 MetS 成分，67 名患者没有 MetS 成分。队列在 BIA 评估时的平均年龄为 11.5±3.6 岁。有 MetS 成分的个体年龄较大（P=0.045），BMI z 分数较高（P<0.001），总脂肪和躯干脂肪百分比较高（P<0.001），肌肉-脂肪比 z 分数较低（P=0.018），肌肉减少症指数较高（P=0.05），收缩压百分位数较高（P=0.001），甘油三酯水平较高（P=0.009），甘油三酯/高密度脂蛋白胆固醇比值较高（P<0.001）。经过性别和年龄调整的模型显示，MetS 成分的诊断与脂肪百分比呈正相关（比值比=1.087，置信区间[1.010-1.171]，P=0.027），但与 BMI z 分数无关（P=0.138）。
我们发现，在儿童期发病的乳糜泻患者中，脂肪百分比与 MetS 成分的发生风险相关，而体重指数无关。预防干预应针对身体成分的改善。
乳糜泻患儿心血管代谢风险的文献较少。我们的分析显示，每五个乳糜泻儿童和青少年中就有两个至少存在一个代谢综合征（MetS）成分。在我们的队列中，脂肪百分比的增加而不是 BMI z 分数的增加预测了 MetS 成分的存在。这些发现表明，乳糜泻儿童和青少年的体重状况并不能反映他们患 MetS 成分的风险。身体成分分析应作为乳糜泻患儿临床评估的一个组成部分。
