title: Cardiovascular disease risk factor profiles in children with celiac disease on gluten-free diets.
abstract: OBJECTIVE
  To describe the cardiovascular disease (CVD) risk factors in a population of children with celiac disease (CD) on a gluten-free diet (GFD).
  
  
  METHODS
  This cross-sectional multicenter study was performed at Schneider Children's Medical Center of Israel (Petach Tiqva, Israel), and San Paolo Hospital (Milan, Italy). We enrolled 114 CD children in serologic remission, who were on a GFD for at least one year. At enrollment, anthropometric measurements, blood lipids and glucose were assessed, and compared to values at diagnosis. The homeostasis model assessment-estimated insulin resistance was calculated as a measure of insulin resistance.
  
  
  RESULTS
  Three or more concomitant CVD risk factors [body mass index, waist circumference, low density lipoprotein (LDL) cholesterol, triglycerides, blood pressure and insulin resistance] were identified in 14% of CD subjects on a GFD. The most common CVD risk factors were high fasting triglycerides (34.8%), elevated blood pressure (29.4%), and high concentrations of calculated LDL cholesterol (24.1%). On a GFD, four children (3.5%) had insulin resistance. Fasting insulin and HOMA-IR were significantly higher in the Italian cohort compared to the Israeli cohort (P < 0.001). Children on a GFD had an increased prevalence of borderline LDL cholesterol (24%) when compared to values (10%) at diagnosis (P = 0.090). Trends towards increases in overweight (from 8.8% to 11.5%) and obesity (from 5.3% to 8.8%) were seen on a GFD.
  
  
  CONCLUSIONS
  This report of insulin resistance and CVD risk factors in celiac children highlights the importance of CVD screening, and the need for dietary counseling targeting CVD prevention.
authors.affiliation: Lorenzo Norsa, Elvira Verduci, Diana Ghisleni, Enrica Riva, Marcello Giovannini, Department of Pediatrics, San Paolo Hospital University of Milan, 20142 Milan, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Norsa
authors.forename: Raanan
authors.initials: R
authors.lastname: Shamir
authors.forename: Noam
authors.initials: N
authors.lastname: Zevit
authors.forename: Elvira
authors.initials: E
authors.lastname: Verduci
authors.forename: Corina
authors.initials: C
authors.lastname: Hartman
authors.forename: Diana
authors.initials: D
authors.lastname: Ghisleni
authors.forename: Enrica
authors.initials: E
authors.lastname: Riva
authors.forename: Marcello
authors.initials: M
authors.lastname: Giovannini
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D002446:Celiac Disease / Q000097:blood / Q000150:complications / Q000178:diet therapy / Q000453:epidemiology*; D002648:Child; D055050:Diet, Gluten-Free; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D007557:Israel / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D012307:Risk Factors
chemical_list: D008055:Lipids
keywords: Cardiovascular disease risk factors; Celiac disease; Children; Cholesterol; Gluten-free diet; Hyperlipidemia; Insulin resistance
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