Minireviews
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Aug 8, 2017; 6(3): 143-148
Published online Aug 8, 2017. doi: 10.5409/wjcp.v6.i3.143
Cardiometabolic risk factors in children with celiac disease on a gluten-free diet
Caterina Anania, Lucia Pacifico, Francesca Olivero, Francesco Massimo Perla, Claudio Chiesa
Caterina Anania, Lucia Pacifico, Francesca Olivero, Francesco Massimo Perla, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy
Claudio Chiesa, Institute of Translational Pharmacology, National Research Council, 00133 Rome, Italy
Author contributions: Anania C, Pacifico L and Chiesa C designed the study, analyzed the data and wrote the manuscript; Olivero F and Perla FM collected the data; all the authors participated in the critical review and in the final approval of the manuscript.
Conflict-of-interest statement: There are no potential conflicts of interest relevant to this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Claudio Chiesa, MD, Institute of Translational Pharmacology, National Research Council, Via Fosso del Cavaliere 100, 00133 Rome, Italy. claudio.chiesa@ift.cnr.it
Telephone: +39-06-49979215 Fax: +39-06-49979216
Received: February 26, 2017
Peer-review started: February 28, 2017
First decision: May 5, 2017
Revised: May 8, 2017
Accepted: June 6, 2017
Article in press: June 7, 2017
Published online: August 8, 2017
Abstract

Celiac disease (CD) is an immune-mediated systemic condition evoked by gluten and related prolamines in genetically predisposed subjects. It is characterised by a variable combination of gluten-dependent clinical symptoms, CD-specific antibodies, HLA-DQ2 and HLA-DQ8 haplotypes, and enteropathy. The only therapy of CD consists of a life-long gluten free diet (GFD). Strict GFD adherence results in full clinical, serological and histological remission, avoiding long-term complications in CD patients. However, this diet is not without problems. Gluten free products have high levels of lipids, sugar and salt to improve food palatability and consistency, and subjects with CD show an excessive consumption of hypercaloric and hyperlipidic foods to compensate dietetic restriction. GFD may therefore have a negative impact on cardiometabolic risk factors such as obesity, serum lipid levels, insulin resistance, metabolic syndrome, and atherosclerosis. In adults, some studies have suggested that GFD have a beneficial effect on cardiovascular profile, whereas others have shown an atherogenic effect of GFD. In children, very few studies are available on the issue. Thus, the aim of the present narrative review was to analyze the current clinical evidence on the impact of GFD on cardiometabolic risk factors in children with CD.

Keywords: Celiac disease, Children, Gluten free diet, Cardiometabolic risk, Atherosclerosis

Core tip: Recent epidemiological studies suggest that gluten free diet (GFD) may have adverse effects on body weight, serum lipid levels and insulin resistance in youths with celiac disease (CD). Screening for cardiometabolic risk factors in celiac children is to be recommended not only at diagnosis but also during follow-up since an early intervention may prevent cardiovascular morbidity. Dietary guidance over time, targeting obesity and other components of metabolic syndrome besides monitoring adherence to GFD may be warranted in CD youths.