Journal Mobile Options
Table of Contents
Vol. 26, No. 2, 2008
Issue release date: April 2008
Dig Dis 2008;26:128–133
(DOI:10.1159/000116770)

Metabolic and Nutritional Features in Adult Celiac Patients

Malandrino N. · Capristo E. · Farnetti S. · Leggio L. · Abenavoli L. · Addolorato G. · Gasbarrini G.
To view the fulltext, log in and/or choose pay-per-view option

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Celiac disease (CD) is a chronic immune-mediated gluten-dependent enteropathy induced by ingestion of gluten-containing products, characterized by intestinal malabsorption and subtotal or total atrophy of intestinal villi, which improves after gluten-free diet (GFD). Untreated patients affected by the classic form of CD are at high risk of malnutrition, but an impairment of nutritional status is frequently reported also in patients with the subclinical form of the disease. Strict adherence to a GFD greatly improves nutritional status, inducing an increase in fat and bone compartments, but does not completely normalize body composition. A lack of improvement in nutritional status may identify incomplete adherence to GFD treatment. Evidence has shown lower body weights and lower fat mass and fat-free mass contents in CD patients. Untreated CD patients oxidize more carbohydrates as energy substrate compared to treated subjects. In addition, circulating ghrelin concentration was reduced after GFD treatment as a possible consequence of body composition improvement, while leptin did not correlate with the changes in body composition and substrate oxidation in patients with CD. A significant correlation was reported between ghrelin and the degree of severity of intestinal mucosal lesions. CD patients might show an alteration in lipid metabolism, i.e. low serum total and high- density lipoprotein-cholesterol as a consequence of lipid malabsorption and decreased intake. In conclusion, weight loss and nutritional deficiencies are relevant clinical features in CD. Thus, an early and accurate evaluation of nutritional status and energy metabolism represents a fundamental tool in the management of CD patients.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Corazza GR, Gasbarrini G: Coeliac disease in adults. Baillieres Clin Gastroenterol 1995;9:329–350.
  2. Craig D, Robins G, Howdle PD: Advance in celiac disease. Curr Opin Gastroenterol 2007;23:142–148.
  3. Sollid LM: Coeliac disease: dissecting a complex inflammatory disorder. Nat Rev Immunol 2002;2:647–655.
  4. Farrell RJ, Kelly CP: Celiac sprue. N Engl J Med 2002;346:180–188.
  5. Capristo E, Addolorato G, Mingrone G, De Gaetano A, Greco AV, Tataranni PA, Gasbarrini G: Change in body composition, substrate oxidation, and resting metabolic rate in adult celiac disease patients after one-year gluten-free diet treatment. Am J Clin Nutr 2000;72:76–81.

    External Resources

  6. Corazza GR, Di Sario A, Sacco G, Zoli G, Treggiari EA, Brusco G, Gasbarrini G: Subclinical coeliac disease: an anthropometric assessment. J Intern Med 1994;236:183–187.
  7. Addolorato G, Capristo E, Ghittoni G, Valeri C, Mascianà R, Ancona C, Gasbarrini G: Anxiety but not depression decreases in celiac patients after one-year of gluten free diet: a longitudinal study. Scand J Gastroenterol 2001;36:502–506.
  8. Green PHR: The many faces of celiac disease: clinical presentation of celiac disease in the adult population. Gastroenterology 2005;128:S74–S78.
  9. Zone JJ: Skin manifestations in celiac disease. Gastroenterology 2005;128:S87–S91.

    External Resources

  10. Pietzak MM: Follow-up of patients with celiac disease: achieving compliance with treatment. Gastroenterology 2005;128:S135–S141.
  11. Valdimarsson T, Toss G, Löfman O, Ström M: Three years’ follow-up of bone density in adult coeliac disease: significance of secondary hyperparathyroidism. Scand J Gastroenterol 2000;35:274–280.
  12. Gonzalez D, Mazure R, Mautalen C, Vazquez H, Bai J: Body composition and bone mineral density in untreated and treated patients with celiac disease. Bone 1995;16:231–234.
  13. McFarlane XA, Bhalla AK, Robertson DAF: Effect of a gluten-free diet on osteopenia in adults with newly diagnosed coeliac disease. Gut 1996;39:180–184.
  14. Corazza GR, Di Sario A, Ceccheti L, Jorizzo RA, Di Stefano M, Minguzzi L, Brusco G, Bernardi M, Gasbarrini G: Influence of pattern of clinical presentation and of gluten-free diet on bone mass and metabolism in adult coeliac disease. Bone 1996;18:525–530.
  15. Hallert C, Grant C, Grehn S, Grännö C, Hultén S, Midhagen G, Ström M, Svensson H, Valdimarsson T: Evidence of poor vitamin status in coeliac patients on a gluten-free diet for 10 years. Aliment Pharmacol Ther 2002;16:1333–1339.
  16. Dahele A, Ghosh S: Vitamin B12 deficiency in untreated celiac disease. Am J Gastroenterol 2001;96:745–750.
  17. Fasano A, Berti I, Gerarduzzi T, Not T, Colletti RB, Drago S, Elitsur Y, Green PH, Guandalini S, Hill ID, Pietzak M, Ventura A, Thorpe M, Kryszak D, Fornaroli F, Wasserman SS, Murray JA, Horvath K: Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med 2003;163:286–292.
  18. Annibale B, Severi C, Chistolini A, Antonelli G, Lahner E, Marcheggiano A, Iannoni C, Monarca B, Delle Fave G: Efficacy of gluten-free diet alone on recovery from iron-deficiency anemia in adult celiac patients. Am J Gastroenterol 2001;96:132–137.
  19. Kupper C: Dietary guidelines and implementation for celiac disease. Gastroenterology 2005;128:S121–S127.
  20. Capristo E, Mingrone G, Addolorato G, Greco AV, Corazza GR, Gasbarrini G: Differences in metabolic variables between adult coeliac patients at diagnosis and patients on a gluten-free diet. Scand J Gastroenterol 1997;32:1222–1229.
  21. Ojetti V, Nucera G, Migneco A, Gabrielli M, Lauritano C, Danese S, Zocco MA, Nista EC, Cammarota G, De Lorenzo A, Gasbarrini G, Gasbarrini A: High prevalence of celiac disease in patients with lactose intolerance. Digestion 2005;71:106–110.
  22. Mohn A, Cerruto M, Iafusco D, Prisco F, Tumini S, Stoppoloni O, Chiarelli F: Celiac disease in children and adolescents with type I diabetes: importance of hypoglycemia. J Pediatr Gastroenterol Nutr 2001;32:37–40.
  23. Salinari S, Bertuzzi A, Mingrone G, Capristo E, Scarfone A, Greco AV, Heymsfield SB: Bioimpedance analysis: a useful technique for assessing appendicular lean soft tissue mass and distribution. J Appl Physiol 2003;94:1552–1556.
  24. Pietrobelli A, Wang Z, Formica C, Heymsfield SB: Dual-energy x-ray absorptiometry: fat estimation errors due to variation in soft tissue hydration. Am J Physiol 1998;274:E808–E816.
  25. Da Rocha EE, Alves VG, da Fonseca RB: Indirect calorimetry: methodology, instruments and clinical application. Curr Opin Clin Nutr Metab Care 2006;9:247–256.
  26. Bodé S, Hassager E, Gudmand-Hoyer E, Christiansen C: Body composition and calcium metabolism in treated coeliac disease. Gut 1991;32:1342–1345.
  27. Mazure RM, Vazquez H, Gonzalez D, Mautalen C, Soifer G, Cataldi M, Maurino E, Niveloni S, Siccadi AM, Flores D, Pedreira S, Boerr L, Bai JC: Early changes of body composition in asymptomatic celiac disease patients. Am J Gastroenterol 1996;91:726–730.
  28. Capristo E, Addolorato G, Greco AV, Gasbarrini G: Body composition and energy metabolism in celiac disease. Am J Gastroenterol 1998;93:1596–1597.
  29. Przemioslo R, Wright NA, Elia G, Ciclitira PJ: Analysis of crypt cell proliferation in coeliac disease using MI-B1 antibody shows an increase in growth fraction. Gut 1995;36:22–27.
  30. Nakshabendi IM, Downie S, Russel RI, Rennie MJ: Increased rates of duodenal mucosal protein synthesis in vivo in patients with untreated coeliac disease. Gut 1996;39:176–179.
  31. Tataranni PA, Mingrone G, Greco AV, Caradonna P, Capristo E, Raguso CA, De Gaetano A, Tacchino RM, Castagneto M: Glucose-induced thermogenesis in postobese women who have undergone biliopancreatic diversion. Am J Clin Nutr 1994;60:320–326.
  32. Kemppainen T, Uusitupa M, Janatuinen E, Jarvinen R, Julkunen R, Pikkairanen P: Intakes of nutrients and nutritional status in coeliac patients. Scand J Gastroenterol 1995;30:575–579.
  33. Capristo E, Addolorato G, Mingrone G, Scarfone A, Greco AV, Gasbarrini G: Low-serum high-density lipoprotein-cholesterol concentration as a sign of celiac disease. Am J Gastroenterol 2000;95:3331–3332.
  34. Brar P, Kwon GY, Holleran S, Bai D, Tall AR, Ramakrishnan R, Green PHR: Change in lipid profile in celiac disease: beneficial effect of gluten-free diet. Am J Med 2006;119:786–790.
  35. Tolle V, Kadem M, Bluet-Pajot MT, Frere D, Foulon C, Bossu C, Dardennes R, Mounier C, Zizzari P, Lang F, Epelbaum J, Estour B: Balance in ghrelin and leptin plasma levels in anorexia nervosa patients and constitutionally lean women. J Clin Endocrinol Metab 2003;88:109–116.
  36. Maffei M, Halaas J, Ravussin E, Pratley RE, Lee GH, Zhang Y, Fei H, Kim S, Lallone R, Ranganathan S: Leptin levels in human and rodent: measurement of plasma leptin and ob RNA in obese and weight-reduced subjects. Nat Med 1995;1:1155–1161.
  37. Barrenetxe J, Villaro AC, Guembe L, Pascual I, Munoz-Navas M, Barber A, Lostao MP: Distribution of the long leptin receptor isoform in brush border, basolateral membrane, and cytoplasm of enterocytes. Gut 2002;50:797–802.
  38. Kojima M, Hosoda H, Date Y, Nakazato M, Matsuo H, Kangawa K: Ghrelin is a GH-releasing acylated peptide from stomach. Nature 1999;402:656–660.
  39. Shintani M, Ogawa Y, Ebihara K, Aizawa-Abe M, Miyanaga F, Takaya K, Hayashi T, Inoue G, Hosoda K, Kojima M, Kangawa K, Nakao K: Ghrelin, an endogenous growth hormone secretagogue, is a novel orexigenic peptide that antagonizes leptin action through the activation of hypothalamic neuropeptide Y/Y1 receptor pathway. Diabetes 2001;50:227–232.
  40. Wren AM, Seal LJ, Cohen MA, Brynes AE, Frost GS, Murphy KG, Dhillo WS, Ghatei MA, Bloom SR: Ghrelin enhances appetite and increases food intake in humans. J Clin Endocrinol Metab 2001;86:5992–5995.
  41. Gnanapavan S, Kola B, Bustin SA, Morris DG, McGee P, Fairclough P, Bhattacharya S, Carpenter R, Grossman AB, Korbonits M: The tissue distribution of the mRNA of ghrelin and subtypes of its receptor, GHS-R, in humans. J Clin Endocrinol Metab 2002;87:2988–2991.
  42. Capristo E, Farnetti S, Certo M, Mingrone G, Greco AV, Addolorato G, Gasbarrini G: Reduced plasma ghrelin in celiac disease patients. Scand J Gastroenterol 2005;40:430–436.
  43. Saad MF, Bernaba B, Hwu C, Jinagouda S, Fahmi S, Kogosov E, Boyadjian R: Insulin regulates plasma ghrelin concentration. J Clin Endocrinol Metab 2002;87:3997–4000.
  44. Peracchi M, Conte D, Terrani C, Pizzinelli S, Gebbia C, Cappiello V, Spada A, Bardella MT: Circulating ghrelin levels in celiac patients. Am J Gastroenterol 2003;98:2474–2478.
  45. Lanzini A, Magni P, Petroni ML, Motta M, Lanzarotto F, Villanacci V, Amato M, Mora A, Bertolazzi S, Benini F, Ricci C: Circulating ghrelin level is increased in coeliac disease as in functional dyspepsia and reverts to normal during gluten-free diet. Aliment Pharmacol Ther 2006;23:907–913.
  46. Peracchi M, Molteni N, Cantalamessa L, Bardella MT, Peracchi G, Orsatti A, Faggioli P, Bianchi PA: Abnormal growth hormone responsiveness to stimuli in women with active celiac sprue. Am J Gastroenterol 1992;87:580–583.
  47. Addolorato G, Di Giuda D, De Rossi G, Valenza V, Domenicali M, Caputo F, Gasbarrini A, Capristo E, Gasbarrini G: Regional cerebral hypoperfusion in patients with celiac disease. Am J Med 2004;116:312–317.

    External Resources



Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50