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Evidence of poor vitamin status in coeliac patients on a gluten-free diet for 10 years.

Abstract

BACKGROUND

Patients with coeliac disease are advised to keep to a lifelong gluten-free diet to remain well. Uncertainty still exists as to whether this gives a nutritionally balanced diet.

AIM

To assess the vitamin nutrition status of a series of coeliac patients living on a gluten-free diet for 10 years.

METHODS

Thirty adults with coeliac disease (mean age, 55 years; range, 45-64 years; 60% women), in biopsy-proven remission following 8-12 years of dietary treatment, were studied. We measured the total plasma homocysteine level, a metabolic marker of folate, vitamin B-6 and vitamin B-12 deficiency, and related plasma vitamin levels. The daily vitamin intake level was assessed using a 4-day food record. Normative data were obtained from the general population of the same age.

RESULTS

Coeliac patients showed a higher total plasma homocysteine level than the general population, indicative of a poor vitamin status. In accordance, the plasma levels of folate and pyridoxal 5'-phosphate (active form of vitamin B-6) were low in 37% and 20%, respectively, and accounted for 33% of the variation of the total plasma homocysteine level (P < 0.008). The mean daily intakes of folate and vitamin B-12, but not of vitamin B-6, were significantly lower in coeliac patients than in controls.

CONCLUSIONS

Half of the adult coeliac patients carefully treated with a gluten-free diet for several years showed signs of a poor vitamin status. This may have clinical implications considering the linkage between vitamin deficiency, elevated total plasma homocysteine levels and cardiovascular disease. The results may suggest that, when following up adults with coeliac disease, the vitamin status should be reviewed.

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  • Authors+Show Affiliations

    ,

    Coeliac Centre, Faculty of Health Sciences, Linköping University, Sweden. Claes.Hallert@lio.se

    , , , , , , ,

    Source

    MeSH

    Celiac Disease
    Cohort Studies
    Energy Intake
    Female
    Folic Acid
    Glutens
    Homocysteine
    Humans
    Male
    Middle Aged
    Nutritional Status
    Pyridoxal Phosphate
    Remission Induction
    Vitamin B 12
    Vitamins

    Pub Type(s)

    Journal Article
    Multicenter Study
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    12144584

    Citation

    Hallert, C, et al. "Evidence of Poor Vitamin Status in Coeliac Patients On a Gluten-free Diet for 10 Years." Alimentary Pharmacology & Therapeutics, vol. 16, no. 7, 2002, pp. 1333-9.
    Hallert C, Grant C, Grehn S, et al. Evidence of poor vitamin status in coeliac patients on a gluten-free diet for 10 years. Aliment Pharmacol Ther. 2002;16(7):1333-9.
    Hallert, C., Grant, C., Grehn, S., Grännö, C., Hultén, S., Midhagen, G., ... Valdimarsson, T. (2002). Evidence of poor vitamin status in coeliac patients on a gluten-free diet for 10 years. Alimentary Pharmacology & Therapeutics, 16(7), pp. 1333-9.
    Hallert C, et al. Evidence of Poor Vitamin Status in Coeliac Patients On a Gluten-free Diet for 10 Years. Aliment Pharmacol Ther. 2002;16(7):1333-9. PubMed PMID: 12144584.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Evidence of poor vitamin status in coeliac patients on a gluten-free diet for 10 years. AU - Hallert,C, AU - Grant,C, AU - Grehn,S, AU - Grännö,C, AU - Hultén,S, AU - Midhagen,G, AU - Ström,M, AU - Svensson,H, AU - Valdimarsson,T, PY - 2002/7/30/pubmed PY - 2003/2/1/medline PY - 2002/7/30/entrez SP - 1333 EP - 9 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 16 IS - 7 N2 - BACKGROUND: Patients with coeliac disease are advised to keep to a lifelong gluten-free diet to remain well. Uncertainty still exists as to whether this gives a nutritionally balanced diet. AIM: To assess the vitamin nutrition status of a series of coeliac patients living on a gluten-free diet for 10 years. METHODS: Thirty adults with coeliac disease (mean age, 55 years; range, 45-64 years; 60% women), in biopsy-proven remission following 8-12 years of dietary treatment, were studied. We measured the total plasma homocysteine level, a metabolic marker of folate, vitamin B-6 and vitamin B-12 deficiency, and related plasma vitamin levels. The daily vitamin intake level was assessed using a 4-day food record. Normative data were obtained from the general population of the same age. RESULTS: Coeliac patients showed a higher total plasma homocysteine level than the general population, indicative of a poor vitamin status. In accordance, the plasma levels of folate and pyridoxal 5'-phosphate (active form of vitamin B-6) were low in 37% and 20%, respectively, and accounted for 33% of the variation of the total plasma homocysteine level (P < 0.008). The mean daily intakes of folate and vitamin B-12, but not of vitamin B-6, were significantly lower in coeliac patients than in controls. CONCLUSIONS: Half of the adult coeliac patients carefully treated with a gluten-free diet for several years showed signs of a poor vitamin status. This may have clinical implications considering the linkage between vitamin deficiency, elevated total plasma homocysteine levels and cardiovascular disease. The results may suggest that, when following up adults with coeliac disease, the vitamin status should be reviewed. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/12144584/full_citation L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0269-2813&amp;date=2002&amp;volume=16&amp;issue=7&amp;spage=1333 DB - PRIME DP - Unbound Medicine ER -