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June 12-13, 2019 | Edinburgh, Scotland
Pediatrics and Clinical Pediatrics
2nd World Congress on
Current Pediatric Research | Volume: 23
Cardiometabolic risk factors in children with Celiac disease on a gluten-free diet
Francesca Olivero
San Matteo Hospital, Italy
Celiac disease (CD) is an immune-mediated systemic
condition evoked by gluten and related prolamines in
geneticallypredisposedsubjects,characterizedbyavariable
combination of clinical symptoms, CD-specific antibodies,
HLA-DQ2 and HLA-DQ8 haplotypes, and enteropathy. The
only therapy is a life-long gluten free diet (GFD). Strict
GFD adherence results in full clinical, serological and
histological remission, avoiding long-term complications
in CD patients. However, gluten-free products have high
levels of lipids, sugar and salt to improve food palatability
and consistency, and subjects with CD show an excessive
consumption of hypercaloric and hyperlipidic foods to
compensate dietetic restriction. GFD may therefore have
a negative impact on cardiometabolic risk factors such as
obesity, serum lipid levels, insulin resistance, metabolic
syndrome, and atherosclerosis. We analysed the current
clinical evidence on the impact of GFD on cardiometabolic
risk factors in children and adolescents with CD. The
available literature shows conflicting data: the majority
of studies indicate changes in markers associated with
cardiovascular risk. However, these variations do not
constantly point at a better or worse cardiovascular risk
profile. Limitations of most studies comprise the relatively
small sample size, the cross-¬sectional design that does
not permit comparison between pre-¬ and post¬-GFD
values of the evaluated parameters, and the absence of
knowledge of familial history for CVD risk factors. Therefore,
additional longitudinal, well¬ designed studies involving a
large number of children with long-¬term follow¬-up are
necessary to clarify whether prolonged exposure to GFD
might result in an increased cardiometabolic risk. GFD
remains the milestone of CD treatment. Nonetheless,
an in-depth assessment of nutritional status along with
cardiometabolic screening in CD children at diagnosis
and during GFD have to be recommended because an
early intervention may prevent cardiovascular morbidity.
Dietary guidance over time, besides monitoring adherence
to GFD, may therefore be warranted in youths with CD.
Speaker Biography
Francesca Olivero has completed her MD cum laude at the age of 24
years from Sapienza University, Rome, Italy. Now, she is a first-year
paediatric trainee at San Matteo University Hospital of Pavia, Italy.
During medical school she participated to 5 International publications
and she has contributed to the writing of chapters of 3 books. Her work
has been presented as oral presentations at International Conferences.
She has been awarded prizes such as “Accademia Lancisiana prize 2016
- 2017 for new medical graduates for a particularly relevant final thesis”
and the award "excellent graduate 2016-2017" Giornata del Laureato -
Sapienza University of Rome.
e:
Francesca Olivero, Current Pediatric Research, Volume 23
ISSN: 0971-9032