TY - JOUR
T1 - Micronutrient Deficiencies Are Common in Contemporary Celiac Disease Despite Lack of Overt Malabsorption Symptoms
AU - Bledsoe, Adam C.
AU - King, Katherine S.
AU - Larson, Joseph J.
AU - Snyder, Melissa
AU - Absah, Imad
AU - Choung, Rok Seon
AU - Murray, Joseph A.
N1 - Funding Information:
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. 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.
Publisher Copyright:
© 2019 Mayo Foundation for Medical Education and Research
PY - 2019/7
Y1 - 2019/7
N2 - 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.
AB - 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.
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U2 - 10.1016/j.mayocp.2018.11.036
DO - 10.1016/j.mayocp.2018.11.036
M3 - Article
C2 - 31248695
AN - SCOPUS:85068043462
SN - 0025-6196
VL - 94
SP - 1253
EP - 1260
JO - Mayo Clinic proceedings
JF - Mayo Clinic proceedings
IS - 7
ER -