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Overweight in celiac disease: prevalence, clinical characteristics, and effect of a gluten-free diet.
Am J Gastroenterol 2006; 101(10):2356-9AJ

Abstract

BACKGROUND

It is well established that a minority of celiac patients present with "classic" symptoms due to malabsorption. However, few studies have focussed on the distribution of body mass index (BMI) in celiac populations and its relationship to clinical characteristics, or on its response to treatment.

METHODS

We reviewed BMI measurements and other clinical and pathological characteristics from a database of 371 celiac patients diagnosed over a 10-yr period and seen by a single gastroenterologist. To assess response to gluten exclusion, we compared BMI at diagnosis and after 2 yr treatment in patients with serological support for dietary compliance.

RESULTS

Mean BMI was 24.6 kg/m2 (range 16.3-43.5). Seventeen patients (5%) were underweight (BMI < 18.5), 211 (57%) were normal, and 143 (39%) were overweight (BMI > or = 25), including 48 (13% of all patients) in the obese range (BMI > or = 30.0). There was a significant association between low BMI and female gender, history of diarrhea, reduced hemoglobin concentration, reduced bone mineral density (BMD), osteoporosis, and higher grades (subtotal/total) of villous atrophy. Of patients compliant with a gluten-free diet, 81% had gained weight after 2 yr, including 82% of initially overweight patients.

CONCLUSIONS

Few celiac patients are underweight at diagnosis and a large minority is overweight; these are less likely to present with classical features of diarrhea and reduced hemoglobin. Failed or delayed diagnosis of celiac disease may reflect lack of awareness of this large subgroup. The increase in weight of already overweight patients after dietary gluten exclusion is a potential cause of morbidity, and the gluten-free diet as conventionally prescribed needs to be modified accordingly.

Authors+Show Affiliations

Department of Gastroenterology, Altnagelvin Hospital, Londonderry, Northern Ireland, United Kingdom.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17032202

Citation

Dickey, William, and Natalie Kearney. "Overweight in Celiac Disease: Prevalence, Clinical Characteristics, and Effect of a Gluten-free Diet." The American Journal of Gastroenterology, vol. 101, no. 10, 2006, pp. 2356-9.
Dickey W, Kearney N. Overweight in celiac disease: prevalence, clinical characteristics, and effect of a gluten-free diet. Am J Gastroenterol. 2006;101(10):2356-9.
Dickey, W., & Kearney, N. (2006). Overweight in celiac disease: prevalence, clinical characteristics, and effect of a gluten-free diet. The American Journal of Gastroenterology, 101(10), pp. 2356-9.
Dickey W, Kearney N. Overweight in Celiac Disease: Prevalence, Clinical Characteristics, and Effect of a Gluten-free Diet. Am J Gastroenterol. 2006;101(10):2356-9. PubMed PMID: 17032202.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Overweight in celiac disease: prevalence, clinical characteristics, and effect of a gluten-free diet. AU - Dickey,William, AU - Kearney,Natalie, PY - 2006/10/13/pubmed PY - 2006/12/21/medline PY - 2006/10/13/entrez SP - 2356 EP - 9 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 101 IS - 10 N2 - BACKGROUND: It is well established that a minority of celiac patients present with "classic" symptoms due to malabsorption. However, few studies have focussed on the distribution of body mass index (BMI) in celiac populations and its relationship to clinical characteristics, or on its response to treatment. METHODS: We reviewed BMI measurements and other clinical and pathological characteristics from a database of 371 celiac patients diagnosed over a 10-yr period and seen by a single gastroenterologist. To assess response to gluten exclusion, we compared BMI at diagnosis and after 2 yr treatment in patients with serological support for dietary compliance. RESULTS: Mean BMI was 24.6 kg/m2 (range 16.3-43.5). Seventeen patients (5%) were underweight (BMI < 18.5), 211 (57%) were normal, and 143 (39%) were overweight (BMI > or = 25), including 48 (13% of all patients) in the obese range (BMI > or = 30.0). There was a significant association between low BMI and female gender, history of diarrhea, reduced hemoglobin concentration, reduced bone mineral density (BMD), osteoporosis, and higher grades (subtotal/total) of villous atrophy. Of patients compliant with a gluten-free diet, 81% had gained weight after 2 yr, including 82% of initially overweight patients. CONCLUSIONS: Few celiac patients are underweight at diagnosis and a large minority is overweight; these are less likely to present with classical features of diarrhea and reduced hemoglobin. Failed or delayed diagnosis of celiac disease may reflect lack of awareness of this large subgroup. The increase in weight of already overweight patients after dietary gluten exclusion is a potential cause of morbidity, and the gluten-free diet as conventionally prescribed needs to be modified accordingly. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/17032202/Overweight_in_celiac_disease:_prevalence_clinical_characteristics_and_effect_of_a_gluten_free_diet_ L2 - http://Insights.ovid.com/pubmed?pmid=17032202 DB - PRIME DP - Unbound Medicine ER -