title: Celiac disease in normal-weight and overweight children: clinical features and growth outcomes following a gluten-free diet.
abstract: OBJECTIVE
  There are few data on pediatric celiac disease in the United States. The aim of our study was to describe the presentation of celiac disease among children with a normal and an elevated body mass index (BMI) for age, and to study their BMI changes following a gluten-free diet (GFD).
  
  
  METHODS
  One hundred forty-two children (age 13 months-19 years) with biopsy-proven celiac disease, contained in a registry of patients studied at our center from 2000 to 2008, had follow-up growth data available. Patients' height, weight, and BMI were converted to z scores for age and grouped by BMI as underweight, normal, and overweight. Compliance was confirmed using results of serological assays, and data of noncompliant patients were analyzed separately. Data were analyzed during the observation period and were expressed as change in height, weight, and BMI z score per month of dietary treatment.
  
  
  RESULTS
  Nearly 19% of patients had an elevated BMI at diagnosis (12.6% overweight, 6% obese) and 74.5% presented with a normal BMI. The mean duration of follow-up was 35.6 months. Seventy-five percent of patients with an elevated BMI at diagnosis decreased their BMI z scores significantly after adherence to a GFD, normalizing it in 44% of cases. Of patients with a normal BMI at diagnosis, weight z scores increased significantly after treatment, and 13% became overweight.
  
  
  CONCLUSIONS
  Both normal weight and overweight frequently occur in North American children presenting with celiac disease. A GFD may have a beneficial effect upon the BMI of overweight and obese children with celiac disease.
authors.affiliation: Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Columbia University Medical Center, New York 10032, USA. nr2268@columbia.edu
authors.forename: Norelle Rizkalla
authors.initials: NR
authors.lastname: Reilly
authors.forename: Kathleen
authors.initials: K
authors.lastname: Aguilar
authors.forename: Benjamin G
authors.initials: BG
authors.lastname: Hassid
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Cheng
authors.forename: Amy R
authors.initials: AR
authors.lastname: Defelice
authors.forename: Philip
authors.initials: P
authors.lastname: Kazlow
authors.forename: Govind
authors.initials: G
authors.lastname: Bhagat
authors.forename: Peter H
authors.initials: PH
authors.lastname: Green
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001835:Body Weight; D002446:Celiac Disease / Q000150:complications / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D055050:Diet, Gluten-Free; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009765:Obesity / Q000150:complications / Q000178:diet therapy / Q000453:epidemiology; D050177:Overweight / Q000150:complications / Q000178:diet therapy / Q000453:epidemiology*; D010349:Patient Compliance; D015995:Prevalence; D012044:Regression Analysis; D012189:Retrospective Studies; D013851:Thinness / Q000503:physiopathology; D014481:United States / Q000453:epidemiology; D055815:Young Adult