Increased serum high-density lipoprotein-cholesterol concentration in celiac disease after gluten-free diet treatment correlates with body fat stores

J Clin Gastroenterol. Nov-Dec 2009;43(10):946-9. doi: 10.1097/MCG.0b013e3181978e4d.


Background: Low high-density lipoprotein-cholesterol (HDL-C) concentration correlates with increased cardiovascular risk. A great prevalence of celiac disease (CD) was reported among patients with low HDL-C concentration, and gluten-free diet (GFD) treatment seems to normalize lipid profile. We evaluated blood lipids and body composition in 26 CD patients with low HDL-C level (<1.0 mmol/L) at diagnosis and after GFD.

Study: A case-control study.

Methods: The diagnosis was based on histologic evidence of subtotal or total duodenal villous atrophy. Patients were studied before and after GFD treatment (14.2+/-1.4 mo) with biopsy-proven return to normal of the duodenal mucosa. HDL-C was enzymatically assessed after precipitation of very low-density lipoprotein and low-density lipoprotein with heparin-magnesium. Apolipoprotein (Apo)-AI level was assessed by immunoturbidimetric assay; triglycerides by an enzymatic colorimetric method. Body composition was assessed by dual-energy x-ray absorptiometry.

Results: Body composition improved after GFD, with increasing body weight (P<0.05) essentially owing to increased fat mass (FM) (P<0.01), rather than fat-free mass (P=0.064). Total cholesterol and HDL-C were lower in untreated compared with treated patients (P<0.001 and P<0.0001). Apo-AI level increased significantly after GFD (1.20+/-0.22 vs. 1.46+/-0.17 g/L; P<0.0001). Apo-AI, sex, and FM were all significant determinants of HDL-C level; a positive correlation (R=0.68; P<0.0001) was found between increase in HDL-C level and in FM after GFD treatment.

Conclusions: Restoration of lipid profile in CD patients after GFD treatment may be explained by an increase in both Apo-AI secretion by intestinal cells and body fat stores.

MeSH terms

  • Absorptiometry, Photon / methods
  • Adipose Tissue / metabolism*
  • Apolipoprotein A-I / metabolism*
  • Body Composition
  • Case-Control Studies
  • Celiac Disease / diet therapy*
  • Celiac Disease / metabolism
  • Cholesterol, HDL / blood
  • Diet, Gluten-Free*
  • Female
  • Follow-Up Studies
  • Humans
  • Intestinal Mucosa / metabolism
  • Intestines / cytology
  • Male
  • Sex Factors


  • Apolipoprotein A-I
  • Cholesterol, HDL