Table 7: The Effects of a GFD on Idiopathic Short Stature in Patients with Asymptomatic Celiac Disease.
|
Study Country N |
Study Design Outcomes Recruitment |
Patient Population Symptoms | Celiac Disease diagnosis criteria Short Stature definition |
Withdrawals GFD compliance |
Effects of GFD |
|---|---|---|---|---|---|
|
Cacciari et al. (14) (1985) Italy N= 104 |
• Study design Case Series, before-after comparison F-up: 3 to 33 mos • Recruitment All children with short stature and CD with positive small bowel biopsy but no GI symptoms who attended the pediatric clinic. |
• Symptoms No GI symptoms • Patient Characteristics Idiopathic short stature: 88/104 (84.6%) Mean age: 9.4 to 13.4 yrs (2.8-16.8) Bone age delay (% of chronologic age): 16.6% - 28.2% • Participation rate Not reported |
• Celiac disease diagnosis Serology (AGA) confirmed by small bowel biopsy • Short stature definition < 3rd percentile |
• Withdrawals 6/16 (37.5%) – not followed after GFD. • GFD Compliance Not reported |
• Effect of GFD on height velocity SDS N=10 Improvement: 6/10 (60.0%) GFD duration: 6-33 mos Statistical significance of changes not provided Mean Height velocity SDS (range), N=9 Before GFD: - 1.81 (-1.2 to 2.4) After GFD: + 0.49 (-5.0 to 6.7) GFD duration: 3 to 12 mos* |
|
Bonamico et al. (13)(1992) Italy N=29 |
• Study design Case series, before-after comparison F-up: unclear • Recruitment Children with short stature and CD with positive small bowel biopsy and no GI symptoms referred to the endocrinology clinic. No somatic, cardiac, or renal malformations or chromosomal abnormalities |
• Symptoms No GI symptoms • Patient Characteristics Mean age: 8.4 yrs ± 3.1 Growth velocity: from -2 SD below average to 25th percentile Growth delay SD, mean (range): -2.7 SD (-2, 3.7) GH deficiency: 5/14 (36%) • Participation rate Not reported |
• Celiac disease diagnosis Small bowel biopsy • Short stature definition Height < 3rd percentile |
• Withdrawals 0 • GFD Compliance Not reported |
• Effect of GFD on growth velocity N=29 29/29 (100%) significant acceleration of growth velocity Growth velocity Before GFD: -2.3 SD Post GFD: + 3.7 SD GFD duration: not clear |
|
Cacciari et al. (15) (1991) Italy N=11 |
• Study design Case series, before-after comparison F-up: 3 yrs • Recruitment Children with short stature diagnosed with CD (positive biopsy and AGA serology) and no GI symptoms. |
• Symptoms No GI symptoms • Patient Characteristics Mean chronological age Male: 12.1 yrs (6.2-19.2) Female: 11.7 yrs (9.6-15) Mean bone age Male: 8.9 yrs (3.8-14) Female: 9.9 yrs (7.5-11.7) • Participation rate Not reported |
• Celiac disease diagnosis Small bowel biopsy • Short stature definition Height < 3rd percentile |
• Withdrawals Not reported • GFD Compliance Not reported |
• Effect of GFD on growth, GFD duration: 3 yrs N=11 Mean chronological age height SDS ± SD: Baseline: -2.52 ± 0.83 Yr 1: -2.23 ± 0.77 Yr 2: -1.99 ± 0.80 Yr 3: -1.69 ± 0.87 p value not reported |
AGA antigliadin antibody; CD celiac disease; f-up follow-up; GFD gluten-free diet; GH growth hormone; GI gastrointestinal; mos months; SD standard deviation; SDS standard deviation score; yr year
*
1st evaluation reported in the publication was used in this table