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a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2014; 68(4): 319-324.

Celiac disease – body mass index in patients upon diagnosis and the effect of a gluten-free diet

Boris Pekárek  , Božena Pekárková1, Juraj Hromec, Ľubomír Jurgoš  2

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A significant portion of patients with celiac disease do not suffer with developed symptoms of malabsorption syndrome. So far, only a few studies have focused on the body mass index (BMI) in patients with celiac disease and of the impact of a gluten-free diet. The only known effective treatment for celiac disease is a gluten-free diet, and therefore since 2005 certain basic prescription gluten-free products have been available in Slovak pharmacies and subsidised by the government. Aims and methods: The main focus was to assess the number of overweight or obese patients diagnosed with CD and to assess how a gluten-free diet affects BMI, because anticipated weight gain could negatively affect the future morbidity of overweight or obese patients. With a view to the implementation of a partial cover of prescription gluten-free foods by health insurance, we tried to assess the benefits of such a measure. The survey was made as a retrospective evaluation of 153 patients with histologically proven celiac disease. It was supplemented with a single question regarding the assessment of the impact of prescription gluten-free foods. Results: We confirmed that only a relatively small portion of patients (21.8%) had a BMI at the level of malnutrition and quite a significant portion (14.5%) suffered from being overweight or obese. A statistically significant increase in BMI was only confirmed in the case of patients with initially low or normal BMI, not in the case of overweight or obese patients. The effect of prescription and partial cover of gluten-free foods was positively assessed not only by the patients with a completely gluten-free diet (92.9%) but also by a significant number of patients not adhering to a totally gluten-free diet (80%). We compared adherence to a gluten-free diet in the group diagnosed before the implication of health insurance coverage of gluten-free foods, and the group of patients diagnosed while this option was available. However, there was no statistically significant difference between these two groups (80.1 vs 88.1%) of patients within our statistical sample.


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