B vitamins related to homocysteine metabolism in adults celiac disease patients: a cross-sectional study.
BACKGROUND
The only treatment for celiac disease is the gluten-free diet. Few studies have assessed the nutritional adequacy of this diet, especially of B vitamins related to homocysteine metabolism. The aim of this study was to assess the nutritional status and serum concentrations of B vitamins involved in homocysteine metabolism, and to determine whether the dietary intake of these vitamins are meeting Dietary Reference Intakes in celiac patients.


METHODS
A cross-sectional study enrolled a total of 20 celiac patients (36.3 ± 13.7 years old; 65% women), following strict gluten-free diet (GFD) and 39 healthy controls matched by sex and age. The dietary intake was assessed by 3-day food records, and serum concentrations of homocysteine and vitamins B6, B12, and folate were determined after overnight fasting. Comparisons between the two groups were performed by Student's t test or Mann-Whitney U-test, for continuous variables. Pearson's chi-square test or Fisher's exact test was used for categorical variables. An alpha level of 5% were considered significant.


RESULTS
Celiac patients had lower serum folate concentrations (7.7 ± 3.5 ng/mL, P < 0.05) than controls. All celiac patients had folate intake below the Estimated Average Requirement (EAR) (130.8 ± 53.6 μg/d). However, only a small proportion of celiac patients had hyperhomocysteinemia.


CONCLUSIONS
Celiac patients treated with GFD presented inadequacy of dietary folate intake and low-serum concentrations of folate, suggesting that more attention should be given to the quality of the nutrients offered by the GFD, as it constitutes a lifelong treatment.
Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Av. PH. Rolfs, Campus Universitário, Viçosa, Minas Gerais, CEP 36570-900, Brazil. flaviaxavier@gmail.com.
Flávia Xavier
FX
Valente
Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Av. PH. Rolfs, Campus Universitário, Viçosa, Minas Gerais, CEP 36570-900, Brazil. taticampos.nutri@gmail.com.
Tatiana do Nascimento
Tdo N
Campos
Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Av. PH. Rolfs, Campus Universitário, Viçosa, Minas Gerais, CEP 36570-900, Brazil. nandomoraes@yahoo.com.br.
Luís Fernando de Sousa
LF
Moraes
Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Av. PH. Rolfs, Campus Universitário, Viçosa, Minas Gerais, CEP 36570-900, Brazil. helenhermana@ufv.br.
Helen Hermana Miranda
HH
Hermsdorff
Departamento de Nutrição, Universidade Federal de Juiz de Fora, Campus Governador Valadares, Av. Dr. Raimundo Monteiros Rezende, 330, Governador Valadares, Minas Gerais, 35010-177, Brazil. lcardoso.nutricao@hotmail.com.
Leandro de Morais
Lde M
Cardoso
Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Av. PH. Rolfs, Campus Universitário, Viçosa, Minas Gerais, CEP 36570-900, Brazil. helena.santana@ufv.br.
Helena Maria
HM
Pinheiro-Sant'Ana
Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Av. PH. Rolfs, Campus Universitário, Viçosa, Minas Gerais, CEP 36570-900, Brazil. flaviogilberti@gmail.com.
Flávio Augusto Barros
FA
Gilberti
Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Av. PH. Rolfs, Campus Universitário, Viçosa, Minas Gerais, CEP 36570-900, Brazil. mpeluzio@ufv.br.
Maria do Carmo Gouveia
Mdo C
Peluzio
D000328:Adult; D002446:Celiac Disease / Q000097:blood* / Q000178:diet therapy; D003430:Cross-Sectional Studies; D015930:Diet Records; D055050:Diet, Gluten-Free; D005260:Female; D005492:Folic Acid / Q000097:blood*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D009751:Nutritional Requirements; D009752:Nutritional Status; D014805:Vitamin B 12 / Q000097:blood*; D025101:Vitamin B 6 / Q000097:blood*; D014803:Vitamin B Complex / Q000097:blood*
D006710:Homocysteine; D014803:Vitamin B Complex; D025101:Vitamin B 6; D005492:Folic Acid; D014805:Vitamin B 12