Increased Serum High-density Lipoprotein-Cholesterol Concentration in Celiac Disease After Gluten-free Diet Treatment Correlates With Body Fat Stores

Abstract

Restoration of lipid profile in CD patients after GFD treatment may be explained by an increase in both Apo-AI secretion by intestinal cells and body fat stores.

Markers of inflammation and cardiovascular disease in recently diagnosed celiac disease patients

“…In the current study, patients showed TC and LDL-C levels similar to controls. These findings are in disagreement with the decrease in both parameters previously reported for CD patients[5,51,52]. Patients evaluated in this study also presented lower HDL-C levels.…”

“…Therefore, this alteration could result from a lower synthesis and secretion of apo A-I[56]. Furthermore, longitudinal studies described an increase in HDL-C and apo A-I values after initiation of treatment with GFD[51]. In addition, CD patients presented an increase in TC/HDL-C and apo B/apo A-I ratios[57], which reflect an imbalance between proatherogenic and antiatherogenic lipid factors.…”

Comment on: Leeds et al. High Prevalence of Microvascular Complications in Adults With Type 1 Diabetes and Newly Diagnosed Celiac Disease. Diabetes Care 2011;34:2158–2163

“…Consistent with the increased need for personalized medicine in diabetes (5), all together, these findings (1,4) may contribute to a better understanding of type 1 diabetes and its complications and better care of our diabetic patients.…”

“…Apo A-I has been reported as being synthesized by the liver and the intestine and, more recently, by the vitreous fluid and retinal pigment epithelium (3). Our group previously reported that serum levels of HDL and Apo A-I are decreased in individuals with CD, and subsequent restoration of blood lipid profile is observed after GFD (4). Alterations of the small bowel mucosa could be responsible for decreased intestinal Apo A-I secretion and, consequently, for reduced HDL synthesis (4).…”

“…Our group previously reported that serum levels of HDL and Apo A-I are decreased in individuals with CD, and subsequent restoration of blood lipid profile is observed after GFD (4). Alterations of the small bowel mucosa could be responsible for decreased intestinal Apo A-I secretion and, consequently, for reduced HDL synthesis (4). The reduced intestinal secretion of Apo A-I in individuals with type 1 diabetes affected by CD could contribute to the increased prevalence of DN in these subjects compared with individuals with type 1 diabetes alone and would also be of relevance in the assessment of macrovascular complications in these patients.…”