Routine vitamin A and D evaluation may be useful for children with coeliac disease
Coeliac disease is characterised by an intolerance of gluten, and previous studies have found that its most prominent symptoms arise from proximal intestinal malabsorption (abnormal nutrient absorption in the gastrointestinal tract).
This often leads to vitamin and mineral deficiencies — among the most common of these are vitamin A and D deficiencies, especially in newly diagnosed children.
While the routine control of fat-soluble vitamin levels is recommended for those diagnosed as adults, there is no standard vitamin supplementation or evaluation of fat-soluble vitamins for those diagnosed at a younger age.
Disease-related deficiency
As such, researchers at the Adnan Menderes University Medical Faculty in Turkey conducted a year-long study to evaluate fat-soluble vitamin deficiencies in children who had been recently diagnosed with coeliac disease.
They recruited 102 study subjects aged nine to 13, each weighing between 16.2kg and 22.5kg. Among them, 52 were coeliac patients and 50 were healthy controls.
Of the coeliac patients, 25 were male (48.1%) and 27 (51.9%) were female; the control group had an equal number of male and female participants.
The researchers reported that growth retardation was the most common symptom among the patients (61.5%), followed by abdominal pain (51.9%) and diarrhoea (11.5%).
In addition, their vitamin A and D levels were found to be significantly lower than those of the control group, with deficiencies of both vitamins markedly higher among the patients compared to the healthy controls.
In fact, 49 (92.3%) of the patients had vitamin D insufficiency, and of these, 32 (61.5%) had vitamin D deficiency. The researchers also observed vitamin A deficiency in 17 (32.7%) of the patients.
In the control group, only two (4%) had vitamin D deficiency, while nine (18%) had vitamin D insufficiency; levels of other vitamins were deemed normal.
The researchers reported that the study was limited by single-centre data collection and a small patient sample size, and concluded: "In newly diagnosed children with coeliac disease, a significant lowness was established in vitamin D and A. The evaluation of vitamin A and D levels will be helpful in the course of diagnosis in these patients.
"Future research should involve prospective multi-centre trials with (a) larger number of children from different countries, different climates and different genetic backgrounds, in order to assess the true incidence of fat-soluble vitamin deficiency in paediatric patients with ceoliac disease."
Source: BMC Pediatrics
https://doi.org/10.1186/s12887-018-1107-x
"Fat soluble vitamin levels in children with newly diagnosed celiac disease, a case control study"
Authors: Yavuz Tokgöz, et al.
