Increased serum high-density lipoprotein-cholesterol concentration in celiac disease after gluten-free diet treatment correlates with body fat stores.
BACKGROUND
Low high-density lipoprotein-cholesterol (HDL-C) concentration correlates with increased cardiovascular risk. A great prevalence of celiac disease (CD) was reported among patients with low HDL-C concentration, and gluten-free diet (GFD) treatment seems to normalize lipid profile. We evaluated blood lipids and body composition in 26 CD patients with low HDL-C level (<1.0 mmol/L) at diagnosis and after GFD.


METHODS
A case-control study.


METHODS
The diagnosis was based on histologic evidence of subtotal or total duodenal villous atrophy. Patients were studied before and after GFD treatment (14.2+/-1.4 mo) with biopsy-proven return to normal of the duodenal mucosa. HDL-C was enzymatically assessed after precipitation of very low-density lipoprotein and low-density lipoprotein with heparin-magnesium. Apolipoprotein (Apo)-AI level was assessed by immunoturbidimetric assay; triglycerides by an enzymatic colorimetric method. Body composition was assessed by dual-energy x-ray absorptiometry.


RESULTS
Body composition improved after GFD, with increasing body weight (P<0.05) essentially owing to increased fat mass (FM) (P<0.01), rather than fat-free mass (P=0.064). Total cholesterol and HDL-C were lower in untreated compared with treated patients (P<0.001 and P<0.0001). Apo-AI level increased significantly after GFD (1.20+/-0.22 vs. 1.46+/-0.17 g/L; P<0.0001). Apo-AI, sex, and FM were all significant determinants of HDL-C level; a positive correlation (R=0.68; P<0.0001) was found between increase in HDL-C level and in FM after GFD treatment.


CONCLUSIONS
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.
Capristo
Esmeralda
E
Department of Internal Medicine, Catholic University, Rome, Italy. e.capristo@rm.unicatt.it
Malandrino
Noemi
N
Farnetti
Sara
S
Mingrone
Geltrude
G
Leggio
Lorenzo
L
Addolorato
Giovanni
G
Gasbarrini
Giovanni
G
D015502:Absorptiometry, Photon / Q000379:methods; D000273:Adipose Tissue / Q000378:metabolism*; D016632:Apolipoprotein A-I / Q000378:metabolism*; D001823:Body Composition; D016022:Case-Control Studies; D002446:Celiac Disease / Q000178:diet therapy* / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood; D055050:Diet, Gluten-Free; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000166:cytology; D008297:Male; D012737:Sex Factors
D016632:Apolipoprotein A-I; D008076:Cholesterol, HDL