Muscle abnormalities in coeliac disease: studies on gross motor development and muscle fibre composition, size and metabolic substrates.

In 11 children with coeliac disease gross motor development was assessed before and during diet treatment using the gross motor subscale of the Denver developmental screening test. ATP, creatine phosphate (CP), glycogen and lactate concentrations, muscle fibre size and fibre composition were measured in specimens obtained by needle biopsy from the vastus lateralis muscle. Before treatment, gross motor development was delayed. ATP, and to a lesser extent, CP and glycogen concentrations were lowered compared to a control group. After treatment, gross motor development was normal and no differences in ATP, CP or glycogen concentrations were found compared to the control group. Fibre size seemed unaffected by the disease. The percentage of type 1 fibres was significantly lower before treatment, compared to values obtained during treatment and from the control group. Whether these metabolic changes were due to the coeliac disease per se or the inactivity which it causes was not possible to establish. In humans, only altered neurogenic influence on the muscles has been previously shown to give changes in fibre composition.