Can zinc deficiency be used as a marker for the diagnosis of celiac disease in Turkish children with short stature?

Altuntaş, Buket; Filik, Bülent; Ensarı, Arzu; Zorlu, Pelin; Teziç, Tahsin

doi:10.1046/j.1442-200x.2000.01313.x

Cited by 16 publications

(11 citation statements)

References 13 publications

(16 reference statements)

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“…37 Growth retardation also occurs in zinc deficiency in CD as in present study. 38 We found that serum zinc level is the most reducing one in classical CD. There is a publication claims that GI symptoms are more common in male while the other claims that there is not any difference among males and females according to GI symptoms.…”

mentioning

confidence: 64%

Investigation of celiac disease according to Marsh classification in childhood

Bekdaş

Ünal²,

Demircioğlu

2017

Bangladesh J Med Sci

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Background: Celiac disease (CD) is an autoimmune disorder of the small intestine related to gluten. CD is diagnosed by the evaluation of histologic findings according to the Marsh classification. Objectives: To evaluate the clinical and laboratory differences of CD according to Marsh classification. Patients and method: The records of ≥Marsh 2 histologically diagnosed 132 cases were evaluated. Results: It was determined that 7(5.3%) cases were Marsh 2, 32(24.2%) were Marsh 3a, 73(55.3%) were Marsh 3b, and 20(15.1%) were Marsh 3c. Vomiting in Marsh 2 was significantly lower than Marsh 3b and Marsh 3c (respectively, 14.3% vs. 56.9%, p=0.029; and 14.3% vs. 75%, p=0.005). Hemoglobin was significantly higher in Marsh 2 than Marsh 3b and Marsh 3c (respectively, 11.9±1.7 vs. 10.5±1.6 g/dl, p=0.038 and; 11.9±1.7 vs. 9.8±1.6 g/dl, p=0.005). Positive detection ratio for tTG IgA was significantly lower in Marsh 2 than Marsh 3a, Marsh 3b and Marsh 3c (respectively, 66.7% vs. 100%, p<0.001; 66.7% vs. 100%, p<0.001; and 66.7% vs. 94.1%, p=0.003). After the onset of gluten free diet, the time passed for the disappearance of tTG IgA seropositivity is significantly shorter in Marsh 2 than Marsh 3c (6±3.6 vs. 9.7±2.5 months, p=0.017). Conclusions: Gastrointestinal symptoms are more frequent in patients with severe small intestinal mucosal injury. tTG IgA seropositivity is associated with more severe disease. Clinical and laboratory findings of the patients are exacerbated when histopathological findings improve in CD.

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mentioning

confidence: 64%

Investigation of celiac disease according to Marsh classification in childhood

Bekdaş

Ünal²,

Demircioğlu

2017

Bangladesh J Med Sci

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“…Zinc deficiency has been found in 67% of untreated adult patients. Notably, all three studies reporting zinc levels in pediatric patients with active disease have found levels below the reference value in more than half of the patients, and a prospective randomized controlled trial conducted by Rawal et al even found zinc deficiency to be present in more than 70% of patients [37,47,50].…”

Section: Nutritional Deficiencies At Moment Of Diagnosis In Untreatedmentioning

confidence: 99%

“…Two other important minerals that can cause complications in CD patients when deficient, are zinc and magnesium. As summarized earlier, zinc deficiency is highly prevalent at diagnosis in pediatric and adult CD patient and seems to restore insufficiently when on a GFD [18,24,[34][35][36][37]43,47,50,89].…”

Section: Comorbidities Potentially Related To Nutrient Deficiencies Imentioning

confidence: 99%

“…Classical presenting symptoms of CD such as anorexia and failure to thrive have therefore been linked to zinc deficiency [94]. Altuntas et al, found that zinc deficiency was present in more than half of the patients presenting with short stature that were diagnosed with CD in a pediatric population [50]. And although zinc deficiency appears to remain a relevant problem after institution of a GFD, little is known about the consequences of transient or persistent zinc deficiency in CD [47,89,94].…”

Section: Comorbidities Potentially Related To Nutrient Deficiencies Imentioning

confidence: 99%

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Narrative Review: Nutrient Deficiencies in Adults and Children with Treated and Untreated Celiac Disease

et al. 2020

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Nutrient deficiencies are well recognized as secondary consequences of celiac disease (CD) and closely related to the clinical presentation of affected patients. Despite their clinical significance, consensus is lacking on the pattern and frequency of nutrient deficiencies in CD, the usefulness of their assessment at the time of diagnosis and during follow-up. This review aims to provide an overview of nutrient deficiencies among pediatric and adult CD patients at diagnosis and on a gluten-free diet (GFD), and their potential causes in CD. Secondly, we review their impact on CD management strategies including the potential of nutrient supplementation. A search of Medline, Pubmed and Embase until January 2019 was performed. Despite a high variability between the reported deficiencies, we noted that nutrient deficiencies occur frequently in children and adults with CD at diagnosis and during treatment with a GFD. Both inadequate dietary intake and/or diminished uptake due to intestinal dysfunction contribute to nutrient deficiencies. Most deficiencies can be restored with (long-term) treatment with a GFD and/or supplementation. However, some of them persist while others may become even more prominent during GFD. Our results indicate a lack of comprehensive evidence on the clinical efficacy of nutrient supplementation in CD management highlighting the need for further studies.

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“…Our findings were not consistent with those of other authors researchers as Jameson (24), who reported a correlation between zinc deficiency and the severity of villous atrophy in adults. In addition, studies (25,26) have concluded that serum zinc concentrations were low in newly diagnosed and severely malnourished children with CD. The authors speculated that some of the symptoms of CD (eg, anorexia and reduced growth rate) may be related, in part, to zinc deficiency.…”

Section: Discussionmentioning

confidence: 99%

Zinc homeostasis and gut function in children with celiac disease

Tran¹,

Katsikeros²,

Manton³

et al. 2011

The American Journal of Clinical Nutrition

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Background: Celiac disease (CD) is an immunologic enteropathy triggered by the intake of gluten. It is thought that the enteropathy impairs gut function and absorption. Objective: We assessed the zinc-absorption capacity and smallbowel integrity in children with CD. Design: Children in whom a diagnosis of CD was considered clinically and either confirmed (n = 16; Marsh score 3) or not (n = 22; Marsh score of 0) with a small-bowel biopsy (SBB) were recruited. The fractional absorption of zinc (FAZ) was determined by the administration of an oral 67 Zn dose (2.5 mg) and an intravenous 70 Zn dose (0.2 mg) 2 h before and during the SBB, respectively. Spot urine samples were collected, and zinc isotopic ratios were determined by ion-coupled plasma mass spectrometry. Gut health was assessed by the ingestion of 13 C-sucrose (20 g) after an overnight fast, and breath samples were collected and analyzed by isotope ratio mass spectrometry. Results: There was no difference in FAZ between children with a Marsh score 3 (mean 6 SEM: 0.68 6 0.05) and children with a Marsh score of 0 (0.74 6 0.05). The exchangeable zinc pool (EZP) was significantly (P , 0.05) lower in children with a Marsh score 3 (2.6 6 0.8 mg/kg) than in children with a Marsh score of 0 (3.8 6 1.4 mg/kg). Gut function in children with a Marsh score 3 (4.5 6 0.7% cumulative dose recovered at 90 min) was lower than the lower cutoff of a normal gut-function breath test (5.06% cumulative dose recovered at 90 min) but not significantly different from that in children with a Marsh score of 0 (4.9 6 0.4%). There was a significant (P , 0.01) correlation between zinc absorption and gut function in children with CD. Conclusions: Zinc absorption did not appear below usual amounts in subjects with CD. Children with CD have impaired gut function that may affect their zinc nutritional status as shown by a smaller EZP. However, the EZP decrease in children with CD was not compared with that in healthy control subjects, and its biological meaning is uncertain.Am J Clin Nutr 2011;94:1026-32.

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Can zinc deficiency be used as a marker for the diagnosis of celiac disease in Turkish children with short stature?

Abstract: These results indicate that zinc deficiency is an important problem in CD children with short stature; however, plasma zinc levels are not useful as a screening test for selecting patients for jejunal biopsy.

Cited by 16 publications

References 13 publications

Investigation of celiac disease according to Marsh classification in childhood

Investigation of celiac disease according to Marsh classification in childhood

Narrative Review: Nutrient Deficiencies in Adults and Children with Treated and Untreated Celiac Disease

Zinc homeostasis and gut function in children with celiac disease

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