Vitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients

Nutrients. 2013 Sep 30;5(10):3975-92. doi: 10.3390/nu5103975.

Abstract

Malabsorption, weight loss and vitamin/mineral-deficiencies characterize classical celiac disease (CD). This study aimed to assess the nutritional and vitamin/mineral status of current "early diagnosed" untreated adult CD-patients in the Netherlands. Newly diagnosed adult CD-patients were included (n = 80, 42.8 ± 15.1 years) and a comparable sample of 24 healthy Dutch subjects was added to compare vitamin concentrations. Nutritional status and serum concentrations of folic acid, vitamin A, B₆, B₁₂, and (25-hydroxy) D, zinc, haemoglobin (Hb) and ferritin were determined (before prescribing gluten free diet). Almost all CD-patients (87%) had at least one value below the lower limit of reference. Specifically, for vitamin A, 7.5% of patients showed deficient levels, for vitamin B₆ 14.5%, folic acid 20%, and vitamin B₁₂ 19%. Likewise, zinc deficiency was observed in 67% of the CD-patients, 46% had decreased iron storage, and 32% had anaemia. Overall, 17% were malnourished (>10% undesired weight loss), 22% of the women were underweight (Body Mass Index (BMI) < 18.5), and 29% of the patients were overweight (BMI > 25). Vitamin deficiencies were barely seen in healthy controls, with the exception of vitamin B₁₂. Vitamin/mineral deficiencies were counter-intuitively not associated with a (higher) grade of histological intestinal damage or (impaired) nutritional status. In conclusion, vitamin/mineral deficiencies are still common in newly "early diagnosed" CD-patients, even though the prevalence of obesity at initial diagnosis is rising. Extensive nutritional assessments seem warranted to guide nutritional advices and follow-up in CD treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Body Mass Index
  • Case-Control Studies
  • Celiac Disease / blood
  • Celiac Disease / complications
  • Celiac Disease / diagnosis*
  • Cohort Studies
  • Diet, Gluten-Free
  • Female
  • Ferritins / blood
  • Folic Acid / blood
  • Hemoglobins / metabolism
  • Humans
  • Male
  • Micronutrients / administration & dosage*
  • Micronutrients / deficiency*
  • Middle Aged
  • Netherlands / epidemiology
  • Nutritional Status*
  • Obesity / blood
  • Obesity / complications
  • Obesity / epidemiology
  • Prevalence
  • Vitamin A / blood
  • Vitamin B 12 / blood
  • Vitamin B 6 / blood
  • Vitamin D / blood
  • Weight Loss
  • Young Adult
  • Zinc / blood

Substances

  • Hemoglobins
  • Micronutrients
  • Vitamin A
  • Vitamin D
  • Vitamin B 6
  • Ferritins
  • Folic Acid
  • Zinc
  • Vitamin B 12