High Adherence to a Gluten-Free Diet in Adolescents With Screening-Detected Celiac Disease
2015 (English)In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 60, no 1, 54-59 p.Article in journal (Refereed) Published
Objectives:The aim of the study was to evaluate the gluten-free diet (GFD) adherence after 1 year of follow-up in children with screening-detected celiac disease (CD) in a general population.Methods:A total of 18,325 twelve-year-olds were invited to participate in a population-based CD screening (Exploring the Iceberg of Celiacs in Sweden), of whom 13,279 participated. In 240 children, CD was detected through elevated anti-tissue transglutaminase antibodies 2 (TG2-IgA) and verified by a small-intestinal biopsy. This substudy included 210 children with TG2-IgA, evaluated both at the initial biopsy occasion and at 1-year follow-up. GFD adherence was evaluated by a combination of TG2-IgA measurements and self-reported adherence (n=193).Results:After 1 year, 85% (179/210) had normalized TG2-IgA levels (less than5 U/mL). Among those who had greater than50 U/mL at diagnosis, 25% (16/63) still had elevated TG2-IgA, but for the majority their initial values were more than halved. Most reported a high level of GFD adherence (always 82% [158/193] and often 16% [30/193]), and 75% [145/193] reported always adhering combined with normalized TG2-IgA. Although reporting that they were always adherent, 13 (6.7%) had not yet normalized their TG2-IgA levels completely; however, a majority of these initially had the highest TG2-IgA levels.Conclusions:GFD adherence is high in adolescents with CD detected by screening of the general population of Swedish 12-year-olds. Almost all of them had normalized serology and reported GFD adherence at the 1-year follow-up. A few adolescents who reported GFD adherence, however, had elevated TG2-IgA levels, suggesting more severe disease and/or nonadherence.
Place, publisher, year, edition, pages
Lippincott, Williams andamp; Wilkins , 2015. Vol. 60, no 1, 54-59 p.
adolescents; anti-tissue transglutaminase antibodies; celiac disease; gluten-free diet; screening
IdentifiersURN: urn:nbn:se:liu:diva-114593DOI: 10.1097/MPG.0000000000000571ISI: 000348460100017PubMedID: 25238121OAI: oai:DiVA.org:liu-114593DiVA: diva2:791437
Funding Agencies|FORTE, the Swedish Research Council for Health, Working Life and Welfare; European Union [FP6-2005-FOOD-4B-36383-PREVENTCD]; Swedish Research Council [521-2004-7093, 521-2007-2953]; Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning [222-2004-1918, 222-2007-1394]; Swedish Council for Working Life and Social Research [2005-0802]2015-02-272015-02-262016-03-24