Abstract
Objective
To evaluate micronutrient deficiencies in a contemporary cohort of adult patients
with newly diagnosed celiac disease (CD).
Patients and Methods
This is a retrospective study of prospective adults newly diagnosed with CD from January
1, 2000, through October 31, 2014, at Mayo Clinic. Micronutrient data were collected
for tissue transglutaminase IgA, zinc, 25-hydroxy vitamin D, ferritin, albumin, copper,
vitamin B12, and serum folate. Data were analyzed for absolute number of deficiencies and associations
with age, sex, body mass index, presenting symptoms, and tissue transglutaminase IgA;
each deficiency was assessed using logistic regression. Deficiencies were compared
with age- and sex-matched controls from the National Health and Nutrition Examination
Survey.
Results
In total, 309 patients with CD (196 women and 113 men; mean age, 46.1±15.1 years;
mean body mass index, 25.9 kg/m2) were included. Weight loss was seen in only 25.2% (78/309) of patients. Zinc was
deficient in 59.4% (126/212) of patients with CD compared with 33.2% (205/618) of
controls (P<.001). Albumin was low in 19.7% (24/122) compared with 1.1% of controls (P<.001). Copper was low in 6.4% (13/204) compared with 2.1% (13/618) of controls (P=.003). Vitamin B12 was low in 5.3% (13/244) compared with 1.8% (11/618) of controls (P=.004). Folate was low in 3.6% (6/159) compared with 0.3% (2/618) of controls (P=.002). 25-Hydroxy vitamin D was low in 19.0% (44/213) compared with 18% (111/618)
of controls (P=.72). Ferritin was low in 30.8% (66/214) of patients; no NHANES controls were available
for comparison for ferritin.
Conclusion
Micronutrient deficiencies remain common in adults with CD despite increased nonclassic
presentation. This study provides support for micronutrient assessment at the time
of CD diagnosis.
Abbreviations and Acronyms:
BMI (body mass index), CD (celiac disease), NHANES (National Health and Nutrition Examination Survey)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 25, 2019
Footnotes
Potential Competing Interests: Dr Murray has received grant support from the National Institutes of Health, Immunogenix, and Alba Therapeutics; receives ongoing support from Oberkotter Foundation and Broad Medical Research Program at Crohn's and Colitis Foundation of America; serves on the advisory board of Eli Lily, Amgen, BioLineRx, Celimmune, GlaxoSmithKline, Genentech, Takeda, and Glenmark; serves as a consultant to Boehringer Ingelheim and Intrexon; has a patent with Evelo; and has equity options in Torax. Dr Snyder served on the strategic advisory committee for Inova Diagnostics. The other authors report no competing interests.
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