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Vitamin and Mineral Deficiencies Are Highly Prevalent in Newly Diagnosed Celiac Disease Patients
Department of Nutrition and Dietetics, VU University Medical Centre, P.O. Box 7057, Amsterdam 1007 MB, The Netherlands
Department of Gastroenterology, Celiac Centre Amsterdam, VU University Medical Centre, Amsterdam 1007 MB, The Netherlands
* Author to whom correspondence should be addressed.
Received: 19 July 2013; in revised form: 13 September 2013 / Accepted: 13 September 2013 / Published: 30 September 2013
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.
Keywords: vitamins; minerals; celiac disease; deficiency; adult; Body Mass Index
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Wierdsma, N.J.; van Bokhorst-de van der Schueren, M.A.E.; Berkenpas, M.; Mulder, C.J.J.; van Bodegraven, A.A. Vitamin and Mineral Deficiencies Are Highly Prevalent in Newly Diagnosed Celiac Disease Patients. Nutrients 2013, 5, 3975-3992.
Wierdsma NJ, van Bokhorst-de van der Schueren MAE, Berkenpas M, Mulder CJJ, van Bodegraven AA. Vitamin and Mineral Deficiencies Are Highly Prevalent in Newly Diagnosed Celiac Disease Patients. Nutrients. 2013; 5(10):3975-3992.
Wierdsma, Nicolette J.; van Bokhorst-de van der Schueren, Marian A.E.; Berkenpas, Marijke; Mulder, Chris J.J.; van Bodegraven, Ad A. 2013. "Vitamin and Mineral Deficiencies Are Highly Prevalent in Newly Diagnosed Celiac Disease Patients." Nutrients 5, no. 10: 3975-3992.