A prospective study of catch-up growth among Indian children with celiac disease

Objectives: The study was done to investigate the response of the gluten-free diet (GFD) on growth and other biochemical parameters in newly diagnosed children with celiac disease (CD). We also determined the association of Marsh biopsy classification and the response in haematological parameters am...

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Main Authors: Madhavi Bharadwaj, Ashish Jain, Anand Prakash Dubey, Avinash Lomash, Seema Kapoor
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2020-01-01
Series:Journal of Family Medicine and Primary Care
Subjects:
Online Access:http://www.jfmpc.com/article.asp?issn=2249-4863;year=2020;volume=9;issue=12;spage=5909;epage=5915;aulast=Bharadwaj
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spelling doaj-6ccc5de323a14fc89b1de8cfc4c3112d2021-01-08T04:11:16ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632020-01-019125909591510.4103/jfmpc.jfmpc_1193_20A prospective study of catch-up growth among Indian children with celiac diseaseMadhavi BharadwajAshish JainAnand Prakash DubeyAvinash LomashSeema KapoorObjectives: The study was done to investigate the response of the gluten-free diet (GFD) on growth and other biochemical parameters in newly diagnosed children with celiac disease (CD). We also determined the association of Marsh biopsy classification and the response in haematological parameters among the children with GFD over the follow-up time. Methods: A prospective observational study was conducted for 1.5 years where children aged 1–10 years with newly confirmed CD (as per Marsh classification) without pre-existing chronic disease were enrolled. Individual anthropometry, biochemical and haematological parameters were recorded on enrolment and compared with 1, 3 and 6 months (follow-up) after initiating GFD (as per World Health Organization growth charts). Statistical Analysis: The data were entered in MS Excel spreadsheet and analysis was done using Statistical Package for Social Sciences version 21.0. A P value of < 0.05 was considered significant. Results: A total of 51 (out of 55) children with CD completed 6-month follow-up. A significant improvement in the growth and biochemical parameters was seen at 6-month follow-up with the GFD (P < 0.05). There was a significantly decreasing Hb (at enrolment and at 3 months) with increasing Marsh biopsy grade—it was significantly less with Marsh 3C and more with Marsh 3A. A significantly better %Hb improvement was seen in children with Marsh biopsy 3C as compared to 3A and 3B (P < 0.05). We found no significant association of Marsh biopsy with Malabsorption, type of anaemia and Serum ferritin levels (P > 0.05). Conclusions: GFD showed significant improvement in the growth and development of the child with a significant reduction in anaemia at 6 months. With increasing grade of Marsh biopsy, the severity of anaemia increases but after the initiation of GFD, such children show significantly better improvement in %Hb over time.http://www.jfmpc.com/article.asp?issn=2249-4863;year=2020;volume=9;issue=12;spage=5909;epage=5915;aulast=Bharadwajanthropometryceliac diseasegluten-free dietgrowth
collection DOAJ
language English
format Article
sources DOAJ
author Madhavi Bharadwaj
Ashish Jain
Anand Prakash Dubey
Avinash Lomash
Seema Kapoor
spellingShingle Madhavi Bharadwaj
Ashish Jain
Anand Prakash Dubey
Avinash Lomash
Seema Kapoor
A prospective study of catch-up growth among Indian children with celiac disease
Journal of Family Medicine and Primary Care
anthropometry
celiac disease
gluten-free diet
growth
author_facet Madhavi Bharadwaj
Ashish Jain
Anand Prakash Dubey
Avinash Lomash
Seema Kapoor
author_sort Madhavi Bharadwaj
title A prospective study of catch-up growth among Indian children with celiac disease
title_short A prospective study of catch-up growth among Indian children with celiac disease
title_full A prospective study of catch-up growth among Indian children with celiac disease
title_fullStr A prospective study of catch-up growth among Indian children with celiac disease
title_full_unstemmed A prospective study of catch-up growth among Indian children with celiac disease
title_sort prospective study of catch-up growth among indian children with celiac disease
publisher Wolters Kluwer Medknow Publications
series Journal of Family Medicine and Primary Care
issn 2249-4863
publishDate 2020-01-01
description Objectives: The study was done to investigate the response of the gluten-free diet (GFD) on growth and other biochemical parameters in newly diagnosed children with celiac disease (CD). We also determined the association of Marsh biopsy classification and the response in haematological parameters among the children with GFD over the follow-up time. Methods: A prospective observational study was conducted for 1.5 years where children aged 1–10 years with newly confirmed CD (as per Marsh classification) without pre-existing chronic disease were enrolled. Individual anthropometry, biochemical and haematological parameters were recorded on enrolment and compared with 1, 3 and 6 months (follow-up) after initiating GFD (as per World Health Organization growth charts). Statistical Analysis: The data were entered in MS Excel spreadsheet and analysis was done using Statistical Package for Social Sciences version 21.0. A P value of < 0.05 was considered significant. Results: A total of 51 (out of 55) children with CD completed 6-month follow-up. A significant improvement in the growth and biochemical parameters was seen at 6-month follow-up with the GFD (P < 0.05). There was a significantly decreasing Hb (at enrolment and at 3 months) with increasing Marsh biopsy grade—it was significantly less with Marsh 3C and more with Marsh 3A. A significantly better %Hb improvement was seen in children with Marsh biopsy 3C as compared to 3A and 3B (P < 0.05). We found no significant association of Marsh biopsy with Malabsorption, type of anaemia and Serum ferritin levels (P > 0.05). Conclusions: GFD showed significant improvement in the growth and development of the child with a significant reduction in anaemia at 6 months. With increasing grade of Marsh biopsy, the severity of anaemia increases but after the initiation of GFD, such children show significantly better improvement in %Hb over time.
topic anthropometry
celiac disease
gluten-free diet
growth
url http://www.jfmpc.com/article.asp?issn=2249-4863;year=2020;volume=9;issue=12;spage=5909;epage=5915;aulast=Bharadwaj
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