Body mass index is not a reliable tool in predicting celiac disease in children

BMC Pediatrics

Annelie Carlsson¹  Anneli Ivarsson⁴  Anna Rosén⁴  Lotta Högberg²  Solveig Hammarroth³  Fredrik Norström⁴  Anna Myléus⁴  Maria van der Pals¹ 

[1] Department of Pediatrics, Clinical Sciences, Skåne University Hospital, Malmö, Lund University, SE-205 02 Lund, Sweden;Division of Pediatrics, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Department of Pediatrics in Norrköping, County Council of Östergötland, Norrköping, Sweden;Pediatric Clinic, Norrtälje Hospital, Norrtälje, Sweden;Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden

关键词: Weight;    Screening study;    Height;    Children;    Celiac disease;    Body mass index;   

Others  :  1138671
DOI  :  10.1186/1471-2431-14-165

 received in 2014-03-06, accepted in 2014-06-12,  发布年份 2014

【 摘 要 】

Background

Untreated celiac disease is traditionally believed to be associated with malabsorption and underweight. However, studies describing body mass index (BMI) in individuals at the time of diagnosis have shown contradictory results. We investigated the differences in weight, height, and BMI in 12- year-old children with screening-detected celiac disease compared to their healthy peers.

Methods

In a population-based screening study of 12,632 12-year-old children, blood samples were analyzed for markers of celiac disease. Children with elevated markers were referred for a small bowel biopsy. Weight and height were measured in 239 out of 242 children with screening-detected celiac disease (57.3% girls) and in 12,227 children without celiac disease (48.5% girls). BMI was categorized according to the International Obesity Task Force. Age- and sex-specific cut-off points for underweight, normal weight, and overweight were used.

Results

Children with celiac disease weighed less and were shorter than their peers (median weight 45.2 kg, interquartile range (IQR) 40.2–52.2 kg vs. 47.0 kg, IQR 41.1–54.4 kg, respectively, p = 0.01; median height 156.5 cm, IQR 151.0–162.0 cm vs. 157.5 cm, IQR 152.0–163.0 cm, respectively, p = 0.04). In comparing those with celiac disease to their healthy peers, 4.2% vs. 5.2% were underweight, 82.0% vs. 72.8% were normal weight, and 13.8% vs. 21.9% were overweight, respectively. There was no association between being underweight and the risk of having undiagnosed celiac disease (Odds ratio (OR) 1.3, 95% CI 0.7–2.4), but the risk was significantly lower among overweight children (OR 0.56, 95% CI 0.4–0.8). Median BMI was slightly lower among the children with screening-detected celiac disease compared to their healthy peers (18.6 kg/m², IQR 17.1–19.8 kg/m² vs. 18.8 kg/m², IQR 17.2–21.1 kg/m², respectively, p = 0.05), but most of the celiac disease cases had a normal BMI.

Conclusions

At a population level, children with celiac disease weigh less, are shorter, and have a lower BMI compared to their peers without celiac disease, and this emphasizes the importance of early recognition and treatment of the condition. However, at an individual level, growth parameters are not reliable in establishing the diagnosis.

【 授权许可】

   
2014 van der Pals et al.; licensee BioMed Central Ltd.

【 图 表 】

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