<p>This study aimed to evaluate changes in anthropometric measurements in paediatric coeliac disease (CD) patients following the initiation of a gluten-free diet (GFD), and to identify baseline characteristics associated with growth recovery. An observational study with retrospective data collection of medical records was conducted on paediatric CD patients (2–18&#xa0;years) diagnosed between 2010 and 2020. Diagnosis of CD was established based on the ESPGHAN criteria with and without biopsy. Anthropometric measurements were converted to age- and sex-specific z-scores. Data were collected at diagnosis (T0) and at two time points: T1 (5.5–9&#xa0;months post-diagnosis) and T2 (17–25&#xa0;months post-diagnosis). Univariate generalised linear models and DAG-informed regression models were used for statistical analysis. The study included 439 CD patients (66% female). At diagnosis, mean z-scores for weight-for-age (WAZ) and height-for-age (HAZ) were significantly lower than reference values. Significant increases in WAZ, HAZ and BMI-for-age z-score (BMIZ) were observed from baseline (T0) to T2. Younger age at diagnosis was associated with greater increases in WAZ and HAZ. Children with typical symptoms showed greater growth recovery in WAZ and BMIZ compared to those with atypical symptoms. TTG-IgA levels at T2 were not associated with growth outcomes. <i>Conclusion:</i> Children with CD exhibit significant catch-up growth after starting a GFD, with early and sustained improvements in weight and height. Younger age at diagnosis and typical presentation predict greater growth recovery, underscoring the importance of early detection and treatment.<Table Float="No" ID="Taba"> <tgroup cols="1"> <colspec align="left" colname="c1" colnum="1" /> <tbody> <row> <entry align="left" colname="c1"> <p><b>What is Known:</b></p> <p>• <i>Growth impairment is a common manifestation in children with undiagnosed CD.</i></p> <p>• <i>Changes in the degree of growth recovery in relation to patients' clinical and biochemical profiles are not fully elucidated.</i></p> </entry> </row> <row> <entry align="left" colname="c1"> <p><b>What is New:</b></p> <p>• <i>Paediatric CD patients demonstrate significant height recovery, with mean height z-scores approaching the population average of zero.</i></p> <p>• <i>Younger age at diagnosis and more severe symptoms are associated with greater growth recovery.</i></p> </entry> </row> </tbody> </tgroup> </Table></p>

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Changes in the anthropometric measurements in children and adolescents with coeliac disease over a two-year follow-up

  • Francesca Siccardo,
  • Elena Spada,
  • Massimiliano Turzi,
  • Elena Groppali,
  • Simona Ferraro,
  • Luca Lalli,
  • Cristina Cocuccio,
  • Cecilia Mantegazza,
  • Elena Pozzi,
  • Gianvincenzo Zuccotti

摘要

This study aimed to evaluate changes in anthropometric measurements in paediatric coeliac disease (CD) patients following the initiation of a gluten-free diet (GFD), and to identify baseline characteristics associated with growth recovery. An observational study with retrospective data collection of medical records was conducted on paediatric CD patients (2–18 years) diagnosed between 2010 and 2020. Diagnosis of CD was established based on the ESPGHAN criteria with and without biopsy. Anthropometric measurements were converted to age- and sex-specific z-scores. Data were collected at diagnosis (T0) and at two time points: T1 (5.5–9 months post-diagnosis) and T2 (17–25 months post-diagnosis). Univariate generalised linear models and DAG-informed regression models were used for statistical analysis. The study included 439 CD patients (66% female). At diagnosis, mean z-scores for weight-for-age (WAZ) and height-for-age (HAZ) were significantly lower than reference values. Significant increases in WAZ, HAZ and BMI-for-age z-score (BMIZ) were observed from baseline (T0) to T2. Younger age at diagnosis was associated with greater increases in WAZ and HAZ. Children with typical symptoms showed greater growth recovery in WAZ and BMIZ compared to those with atypical symptoms. TTG-IgA levels at T2 were not associated with growth outcomes. Conclusion: Children with CD exhibit significant catch-up growth after starting a GFD, with early and sustained improvements in weight and height. Younger age at diagnosis and typical presentation predict greater growth recovery, underscoring the importance of early detection and treatment.

What is Known:

Growth impairment is a common manifestation in children with undiagnosed CD.

Changes in the degree of growth recovery in relation to patients' clinical and biochemical profiles are not fully elucidated.

What is New:

Paediatric CD patients demonstrate significant height recovery, with mean height z-scores approaching the population average of zero.

Younger age at diagnosis and more severe symptoms are associated with greater growth recovery.