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Çölyak hastalığı olan çocuklar ile sağlıklı yaşıtlarının erken ateroskleroz belirteçlerinin karşılaştırılması

Year 2022, Volume: 47 Issue: 4, 1600 - 1609, 28.12.2022
https://doi.org/10.17826/cumj.1166923

Abstract

Amaç: Bu çalışmada, pediatrik yaş grubundaki Çölyak hastalarının karotis intima-media kalınlığının (KİMK) ve epikardiyal yağ doku kalınlığının (EYDK) değerlendirilmesi amaçlandı.
Gereç ve Yöntem: Bu kesitsel çalışmada, 5-18 yaş aralığındaki Çölyak hastaları (n=54) ve sağlıklı yaşıtları (n=54) yer aldı. En az son 12 aydır glutensiz diyet uygulayan hastalar dahil edildi. Antropometrik ve biyokimyasal ölçümler yapıldı. Ekokardiyografi ile ölçülen KİMK ve EYDK değerleri hasta ve kontrol grupları arasında karşılaştırıldı.
Bulgular: Hasta ve kontrol gruplarında beden kitle indeksi (17,4±3,0’a karşı 18,4±3,1 kg/m2), kan basıncı (sistolik: 100 (85-120)’e karşı 100 (80-100); diastolik: 60 (40-90)’a karşı 70 (40-90) mmHg) ve lipid profili (total kolesterol: 144,6±30,2’ye karşı 150,8±22,6; trigliserid: 71,5 (27-178)’e karşı 92,5 (34-203) mg/dL) farklılık göstermedi. Hasta grubunda KİMK ve EYDK, kontrol grubuna göre istatistiksel anlamlılıkta daha yüksek saptandı (KİMK: 0,50±0,07 mm’ye karşı 0,45±0,04 mm; EYDK: 5,68±0,90 mm’ye karşı 4,22±0,76 mm). D vitamini yetersizliği riski hasta grubunda 2,68 kat yüksek bulundu (%95 Güven Aralığı = 1,19-6,03).
Sonuç: Çölyak hastalığı olan çocukların sağlıklı yaşıtlarından daha yüksek KİMK ve EYDK değerlerine sahip olduğu görüldü. Ekokardiyografik KİMK ve/veya EYDK ölçümleri, Çölyak hastalığı olan çocuklarda subklinik aterosklerozu değerlendirmenin güvenilir ve basit bir yöntemi olabilir.

Supporting Institution

YOK

Project Number

YOK

Thanks

YOK

References

  • Shannahan S, Leffler DA. Diagnosis and Updates in Celiac Disease. Gastrointest Endosc Clin N Am 2017; 27: 79-92.
  • Kelly CP, Bai JC, Liu E, Leffler DA. Advances in diagnosis and management of celiac disease. Gastroenterology 2015; 148: 1175-86.
  • Schuppan D. Current concepts of celiac disease pathogenesis. Gastroenterology 2000; 119: 234-42.
  • Wei L, Spiers E, Reynolds N, Walsh S, Fahey T, MacDonald TM. The association between coeliac disease and cardiovascular disease. Aliment Pharmacol Ther 2008; 27: 514-9.
  • Hannawi S, Haluska B, Marwick TH, Thomas R. Atherosclerotic disease is increased in recent-onset rheumatoid arthritis: a critical role for inflammation. Arthritis Res Ther 2007; 9: R116.
  • Viljama M, Kaurinen K, Pukkala E, Hervonen K, Reunala T, Collin P. Malignancies and mortality in patients with coeliac disease and dermatitis herpetiformis.a 30-year population-based study. Dig Liv Dis 2006; 38: 374-80.
  • Capristo E, Addolorato G, Mingrone G, Scarfone A, Greco A, Gasbarrini G. Low serum high density lipoprotein cholesterol concentration as a sign of celiac disease. Am J Gastroenterol 2000; 95: 3331-2.
  • van den Oord SC, Sijbrands EJ, ten Kate GL, et al. Carotid intima media thickness for cardiovascular risk assessment: systematic review and meta-analysis. Atherosclerosis 2013; 228: 1-11.
  • Sacks HS, Fain JN. Human epicardial adipose tissue: a review. Am Heart J 2007; 153: 907-17. Demir AM, Kuloğlu Z, Yaman A, Fitöz S, Nergizoglu G, Kansu A. Carotid intima-media thickness and arterial stifness as early markers of atherosclerosis in pediatric celiac disease. Turk J Pediatr 2016; 58: 172-9.
  • Raitakari OT, Juonala M, Kähönen M, et al. Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study. JAMA 2003; 290: 2277-83.
  • Corazza GR, Villanacci V. Coeliac disease. J Clin Pathol 2005; 58: 573-4.
  • De Marchi S, Chiarioni G, Prior M, Arosio E. Young adults with coeliac disease may be at increased risk of early atherosclerosis. Aliment Pharmacol Ther 2013; 38: 162-9.
  • Munns CF, Shaw N, Kiely M, et al. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. J Clin Endocrinol Metab 2016; 101: 394.
  • Bianchi ML. Osteoporosis in children and adolescents. Bone 2007; 41: 486–95.
  • Korkmaz H, Sozen M, Kebapcilar L. Increased arterial stiffness and its relationship with inflammation, insulin, and insulin resistance in celiac disease. Eur J Gastroenterol Hepatol 2015; 27: 1193-9.
  • Santoro L, De Matteis G, Fuorlo M, Giupponi B, Martone AM, Landi F, et al. Atherosclerosis and cardiovascular involvement in celiac disease: the role of autoimmunity and inflammation. Eur Rev Med Pharmacol Sci 2017; 21: 5437-44.
  • de Groot E, van Leuven SI, Duivenvoorden R, et al. Measurement of carotid intima-media thickness to assess progression and regression of atherosclerosis. Nat Clin Pract Cardiovasc Med 2008; 5: 280-8.
  • Shimabukuro M, Hirata Y, Tabata M, et al. Epicardial adipose tissue volume and adipocytokine imbalance are strongly linked to human coronary atherosclerosis. Arterioscler Thromb Vasc Biol 2013; 33: 1077–184.
  • Kim S, Chung J, Kwon B, Song S, Choi W. The associations of epicardial adipose tissue with coronary artery disease and coronary atherosclerosis. Int Heart J 2014; 55: 197–203.
  • Mahfouz RA, Alzaiat A, Yousry A. Relationship of epicardial fat thickness with endothelial and cardiac functions in children with family history of type 2 diabetes mellitus. Echocardiography 2015; 32: 28-33.
  • Elshorbagy HH, Fouda ER, Kamal NM, Bassiouny MM, Fathi WM. Evaluation oF Epicardial Fat and Carotid Intima-Media Thickness in Obese Children. Iran J Pediatr 2016; 26:e2968. doi: 10.5812/ijp.2968.
  • Uluca U, Demir F, Ece A, et al. Assessment of epicardial adipose tissue thickness and the mean platelet volume in children with familial Mediterranean fever. Ital J Pediatr 2015; 41: 15. doi: 10.1186/s13052-015-0120-z.
  • Eren E, Koca B, Ture M, Guzel B. Epicardial adiposity in children with obesity and metabolic syndrome. Iran J Pediatr 2014; 24: 411-7.
  • Baroncini LAV, Sylvestre LC, Baroncini CV, Pecoits RF. Assessment of Carotid Intima-Media Thickness as an Early Marker Of Vascular Damage In Hypertensive Children. Arq Bras Cardiol 2017; 108: 452-7.
  • Ventura A, Magazzù G, Greco L. Duration of exposure to gluten and risk for autoimmune disorders in patients with celiac disaese. Gastroenterology 1999; 117: 297-303.
  • Muscogiuri G, Annweiler C, Duval G, et al. Vitamin D and cardiovascular disease: From atherosclerosis to myocardial infarction and stroke. Int J Cardiol 2017; 230: 577-84.
  • Zanini B, Mazzoncini E, Lanzarotto F, et al. Impact of gluten-free diet on cardiovascular risk factors. A retrospective analysis in a large cohort of coeliac patients. Dig Liver Dis 2013; 45: 810-5.
  • Martin J, Geisel T, Maresch C, Krieger K, Stein J. Inadequate nutrient intake in patients with coeliac disease: results from a German dietary survey. Digestion 2013; 87: 240-6.
  • West J, Logan RF, Card TR, Smith C, Hubbard R. Risk of vascular disease in adults with diagnosed coeliac disease: a population-based study. Aliment Pharmacol Ther 2004; 20(1):73-79. doi: 10.1111/j.1365-2036.2004.02008.x.
  • Rybak A, Wierzbicka A, Socha P, et al. Atherosclerotic Risk Factors in Children with Celiac Disease. Gastroenterol Res Pract 2020; 2020: 6138243. doi: 10.1155/2020/6138243.
  • Lewis NR, Sanders DS, Logan RF, Fleming KM, Hubbard RB, West J. Cholesterol profile in people with newly diagnosed coeliac disease: a comparison with the general population and changes following treatment. Br J Nutr 2009; 102(4): 509-513. doi: 10.1017/S0007114509297248.
  • Brar P, Kwon GY, Holleran S, et al. Change in lipid profile in coeliac disease: beneficial effect of gluten free diet. Am J Med 2006; 119: 786-90.
  • Hyder JA, Allison MA, Barrett-Connor E, et al. Bone mineral density and atherosclerosis: the Multi-Ethnic Study of Atherosclerosis. Abdominal Aortic Calcium Study. Atherosclerosis 2010; 209(1): 283-9. doi: 10.1016/j.atherosclerosis.2009.09.011.
  • Boyraz M, Pirgon O, Akyol B, Dundar B, Cekmez F, Eren N. Importance of epicardial adipose tissue thickness measurement in obese adolescents, its relationship with carotid intima-media thickness, and echocardiographic findings. Eur Rev Med Pharmacol Sci 2013; 17: 3309-17.

Comparison of early atherosclerosis markers in children with Celiac disease and their healthy peers

Year 2022, Volume: 47 Issue: 4, 1600 - 1609, 28.12.2022
https://doi.org/10.17826/cumj.1166923

Abstract

Purpose: We aimed to evaluate carotid intima-media thickness (cIMT) and epicardial adipose tissue thickness (EATT) concurrently as early atherosclerotic markers in pediatric patients with Celiac disease.
Materials and Methods: Patients with Celiac disease (n=54) and healthy peers (n=54) aged 5-18 years were enrolled in this cross-sectional study. Patients who followed gluten free diet at least the past 12 months were included. Anthropometric and biochemical measurements were performed. cIMT and EATT were measured by echocardiography and compared between the patient and control groups.
Results: Body mass index (17.4±3.0 vs. 18.4±3.1 kg/m2), blood pressure (systolic: 100 (85-120) vs. 100 (80-100) mmHg; diastolic: 60 (40-90) vs. 70 (40-90) mmHg), and lipid profile (total cholesterol: 144.6±30.2 vs. 150.8±22.6 mg/dL; triglycerides: 71.5 (27-178) vs. 92.5 (34-203) mg/dL) were not different between the patient and control groups, while there were significant differences in cIMT and EATT. The patient group had higher cIMT (0.50±0.07 vs. 0.45±0.04 mm) and EATT (5.68±0.90 vs. 4.22±0.76 mm) than the control group. The risk of vitamin D insufficiency was 2.68 times higher in the patient group (95% CI=1.19-6.03).
Conclusions: Children with Celiac disease had higher cIMT and EATT than healthy peers. cIMT and/or EATT measurements by echocardiography may present as a reliable and easy method to investigate subclinical atherosclerosis in children with Celiac disease.

Project Number

YOK

References

  • Shannahan S, Leffler DA. Diagnosis and Updates in Celiac Disease. Gastrointest Endosc Clin N Am 2017; 27: 79-92.
  • Kelly CP, Bai JC, Liu E, Leffler DA. Advances in diagnosis and management of celiac disease. Gastroenterology 2015; 148: 1175-86.
  • Schuppan D. Current concepts of celiac disease pathogenesis. Gastroenterology 2000; 119: 234-42.
  • Wei L, Spiers E, Reynolds N, Walsh S, Fahey T, MacDonald TM. The association between coeliac disease and cardiovascular disease. Aliment Pharmacol Ther 2008; 27: 514-9.
  • Hannawi S, Haluska B, Marwick TH, Thomas R. Atherosclerotic disease is increased in recent-onset rheumatoid arthritis: a critical role for inflammation. Arthritis Res Ther 2007; 9: R116.
  • Viljama M, Kaurinen K, Pukkala E, Hervonen K, Reunala T, Collin P. Malignancies and mortality in patients with coeliac disease and dermatitis herpetiformis.a 30-year population-based study. Dig Liv Dis 2006; 38: 374-80.
  • Capristo E, Addolorato G, Mingrone G, Scarfone A, Greco A, Gasbarrini G. Low serum high density lipoprotein cholesterol concentration as a sign of celiac disease. Am J Gastroenterol 2000; 95: 3331-2.
  • van den Oord SC, Sijbrands EJ, ten Kate GL, et al. Carotid intima media thickness for cardiovascular risk assessment: systematic review and meta-analysis. Atherosclerosis 2013; 228: 1-11.
  • Sacks HS, Fain JN. Human epicardial adipose tissue: a review. Am Heart J 2007; 153: 907-17. Demir AM, Kuloğlu Z, Yaman A, Fitöz S, Nergizoglu G, Kansu A. Carotid intima-media thickness and arterial stifness as early markers of atherosclerosis in pediatric celiac disease. Turk J Pediatr 2016; 58: 172-9.
  • Raitakari OT, Juonala M, Kähönen M, et al. Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study. JAMA 2003; 290: 2277-83.
  • Corazza GR, Villanacci V. Coeliac disease. J Clin Pathol 2005; 58: 573-4.
  • De Marchi S, Chiarioni G, Prior M, Arosio E. Young adults with coeliac disease may be at increased risk of early atherosclerosis. Aliment Pharmacol Ther 2013; 38: 162-9.
  • Munns CF, Shaw N, Kiely M, et al. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. J Clin Endocrinol Metab 2016; 101: 394.
  • Bianchi ML. Osteoporosis in children and adolescents. Bone 2007; 41: 486–95.
  • Korkmaz H, Sozen M, Kebapcilar L. Increased arterial stiffness and its relationship with inflammation, insulin, and insulin resistance in celiac disease. Eur J Gastroenterol Hepatol 2015; 27: 1193-9.
  • Santoro L, De Matteis G, Fuorlo M, Giupponi B, Martone AM, Landi F, et al. Atherosclerosis and cardiovascular involvement in celiac disease: the role of autoimmunity and inflammation. Eur Rev Med Pharmacol Sci 2017; 21: 5437-44.
  • de Groot E, van Leuven SI, Duivenvoorden R, et al. Measurement of carotid intima-media thickness to assess progression and regression of atherosclerosis. Nat Clin Pract Cardiovasc Med 2008; 5: 280-8.
  • Shimabukuro M, Hirata Y, Tabata M, et al. Epicardial adipose tissue volume and adipocytokine imbalance are strongly linked to human coronary atherosclerosis. Arterioscler Thromb Vasc Biol 2013; 33: 1077–184.
  • Kim S, Chung J, Kwon B, Song S, Choi W. The associations of epicardial adipose tissue with coronary artery disease and coronary atherosclerosis. Int Heart J 2014; 55: 197–203.
  • Mahfouz RA, Alzaiat A, Yousry A. Relationship of epicardial fat thickness with endothelial and cardiac functions in children with family history of type 2 diabetes mellitus. Echocardiography 2015; 32: 28-33.
  • Elshorbagy HH, Fouda ER, Kamal NM, Bassiouny MM, Fathi WM. Evaluation oF Epicardial Fat and Carotid Intima-Media Thickness in Obese Children. Iran J Pediatr 2016; 26:e2968. doi: 10.5812/ijp.2968.
  • Uluca U, Demir F, Ece A, et al. Assessment of epicardial adipose tissue thickness and the mean platelet volume in children with familial Mediterranean fever. Ital J Pediatr 2015; 41: 15. doi: 10.1186/s13052-015-0120-z.
  • Eren E, Koca B, Ture M, Guzel B. Epicardial adiposity in children with obesity and metabolic syndrome. Iran J Pediatr 2014; 24: 411-7.
  • Baroncini LAV, Sylvestre LC, Baroncini CV, Pecoits RF. Assessment of Carotid Intima-Media Thickness as an Early Marker Of Vascular Damage In Hypertensive Children. Arq Bras Cardiol 2017; 108: 452-7.
  • Ventura A, Magazzù G, Greco L. Duration of exposure to gluten and risk for autoimmune disorders in patients with celiac disaese. Gastroenterology 1999; 117: 297-303.
  • Muscogiuri G, Annweiler C, Duval G, et al. Vitamin D and cardiovascular disease: From atherosclerosis to myocardial infarction and stroke. Int J Cardiol 2017; 230: 577-84.
  • Zanini B, Mazzoncini E, Lanzarotto F, et al. Impact of gluten-free diet on cardiovascular risk factors. A retrospective analysis in a large cohort of coeliac patients. Dig Liver Dis 2013; 45: 810-5.
  • Martin J, Geisel T, Maresch C, Krieger K, Stein J. Inadequate nutrient intake in patients with coeliac disease: results from a German dietary survey. Digestion 2013; 87: 240-6.
  • West J, Logan RF, Card TR, Smith C, Hubbard R. Risk of vascular disease in adults with diagnosed coeliac disease: a population-based study. Aliment Pharmacol Ther 2004; 20(1):73-79. doi: 10.1111/j.1365-2036.2004.02008.x.
  • Rybak A, Wierzbicka A, Socha P, et al. Atherosclerotic Risk Factors in Children with Celiac Disease. Gastroenterol Res Pract 2020; 2020: 6138243. doi: 10.1155/2020/6138243.
  • Lewis NR, Sanders DS, Logan RF, Fleming KM, Hubbard RB, West J. Cholesterol profile in people with newly diagnosed coeliac disease: a comparison with the general population and changes following treatment. Br J Nutr 2009; 102(4): 509-513. doi: 10.1017/S0007114509297248.
  • Brar P, Kwon GY, Holleran S, et al. Change in lipid profile in coeliac disease: beneficial effect of gluten free diet. Am J Med 2006; 119: 786-90.
  • Hyder JA, Allison MA, Barrett-Connor E, et al. Bone mineral density and atherosclerosis: the Multi-Ethnic Study of Atherosclerosis. Abdominal Aortic Calcium Study. Atherosclerosis 2010; 209(1): 283-9. doi: 10.1016/j.atherosclerosis.2009.09.011.
  • Boyraz M, Pirgon O, Akyol B, Dundar B, Cekmez F, Eren N. Importance of epicardial adipose tissue thickness measurement in obese adolescents, its relationship with carotid intima-media thickness, and echocardiographic findings. Eur Rev Med Pharmacol Sci 2013; 17: 3309-17.
There are 34 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research
Authors

Derya Karpuz 0000-0002-3007-1403

Özlem Tezol 0000-0001-9994-7832

Merve Türkegün 0000-0002-4405-521X

Yusuf Usta 0000-0002-0101-6501

Project Number YOK
Publication Date December 28, 2022
Acceptance Date November 21, 2022
Published in Issue Year 2022 Volume: 47 Issue: 4

Cite

MLA Karpuz, Derya et al. “Comparison of Early Atherosclerosis Markers in Children With Celiac Disease and Their Healthy Peers”. Cukurova Medical Journal, vol. 47, no. 4, 2022, pp. 1600-9, doi:10.17826/cumj.1166923.