Kasem Ali Sliman Rim, Stein Nili, Elenberg Alter Yigal
Technion - Israel Institute of Technology, Haifa, Israel.
Department of Pediatrics, Clalit Health Care Organization, Carmel Medical Center, Haifa, Israel.
Eur J Pediatr. 2024 Dec 26;184(1):105. doi: 10.1007/s00431-024-05835-6.
This study examined the prevalence of different BMI categories among newly diagnosed pediatric celiac disease (CD) patients in Israel from 2002 to 2018. A retrospective cross-sectional study using the database of Clalit Health Services in Israel included 5520 newly diagnosed CD children aged 2-18 between 2002 and 2018. Data on BMI, gender, ethnicity, and socioeconomic status (SES) were collected and analyzed Of the 5520 CD patients, 57.5% were female, 39.7% had low SES, and 77.1% were Jewish. At diagnosis, 13.1% were underweight, 73% had normal BMI, 9.1% overweight, and 4.8% were obese. Underweight and obese patients tended to be older at diagnosis (9 years) compared with normal and overweight patients (8 years) (P < 0.001). A higher proportion of Arab patients were underweight, while more Jewish patients were obese. Lower SES was significantly associated with increased underweight risk (P < 0.001). Over time, diagnosed patients had improved SES and were less underweight (P < 0.001). Male gender increased obesity risk (OR 1.36 [95% CI 1.06-1.74], P = 0.017), while Arab ethnicity was protective for obesity (OR 0.67 [95% CI, (0.45-0.99)], P = 0.047)Conclusion: Underweight prevalence significantly decreased in the second decade, but no significant change in overweight and obesity was noted. Underweight was associated with older age at diagnosis, poverty, and Arab ethnicity. Obesity was associated with older age and was more frequent in Jewish and male patients. Physicians should have a low threshold for CD screening regardless of BMI status to enable timely diagnosis and treatment to prevent long-term health consequences. What Is Known: • Celiac disease is traditionally associated with underweight due to malabsorption, but recent reports suggest an increasing prevalence of overweight and obesity in pediatric patients at diagnosis What Is New: • This study found that underweight prevalence decreased significantly over time, while overweight and obesity prevalence remained unchanged. Underweight was associated with older age, poverty, and Arab ethnicity, while obesity was more common in Jewish and male patients.
本研究调查了2002年至2018年以色列新诊断的小儿乳糜泻（CD）患者中不同BMI类别的患病率。一项回顾性横断面研究使用了以色列克拉利特健康服务数据库，纳入了2002年至2018年间5520名年龄在2至18岁之间新诊断为CD的儿童。收集并分析了有关BMI、性别、种族和社会经济地位（SES）的数据。在5520名CD患者中，57.5%为女性，39.7%的SES较低，77.1%为犹太人。诊断时，13.1%体重过轻，73%的BMI正常，9.1%超重，4.8%肥胖。与BMI正常和超重的患者（8岁）相比，体重过轻和肥胖的患者诊断时年龄往往较大（9岁）（P<0.001）。较高比例的阿拉伯患者体重过轻，而较多犹太患者肥胖。较低的SES与体重过轻风险增加显著相关（P<0.001）。随着时间的推移，确诊患者的SES有所改善，体重过轻的情况减少（P<0.001）。男性肥胖风险增加（OR 1.36[95%CI 1.06 - 1.74]，P = 0.017），而阿拉伯种族对肥胖有保护作用（OR 0.67[95%CI，(0.45 - 0.99)]，P = 0.047）结论：在第二个十年中，体重过轻的患病率显著下降，但超重和肥胖情况无显著变化。体重过轻与诊断时年龄较大、贫困和阿拉伯种族有关。肥胖与年龄较大有关，在犹太人和男性患者中更常见。已知信息：• 乳糜泻传统上因吸收不良与体重过轻有关，但最近的报告表明小儿患者诊断时超重和肥胖的患病率在增加新发现：• 本研究发现随着时间的推移体重过轻患病率显著下降，而超重和肥胖患病率保持不变。体重过轻与年龄较大、贫困和阿拉伯种族有关，而肥胖在犹太人和男性患者中更常见
