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Capriati T.,Gastroenterology Hepatology and Nutrition Unit | Francavilla R.,University of Bari | Ferretti F.,Hepato Metabolic Diseases Unit | Castellaneta S.,San Paolo Hospital | And 2 more authors.
European Journal of Clinical Nutrition | Year: 2016

We describe the nutritional status of a cohort of celiac disease (CD) children at presentation and during follow-up on gluten-free diet (GFD). Two Italian centers (Rome and Bari) prospectively enrolled 445 biopsy-confirmed CD children, diagnosed between 2009 and 2013. Body Mass Index was used as a measure of nutritional status according to Italian growth charts of Cacciari. The overweight/obese subject was 7.8% at onset and did not significantly increase during follow-up (9.8% at final assessment). The prevalence of overweight/obesity was significantly higher among males than females. Furthermore, overweight/obesity children as compared with those with normal weight were significantly older and had significantly lower levels of tTG antibodies. This study shows that some CD children are obese/overweight at diagnosis; therefore, overweight/obesity can be considered a rare but a possible mode of CD presentation. Thus, CD diagnosis must be considered even in overweight/obese children where this diagnosis can be easily missed. © 2016 Macmillan Publishers Limited All rights reserved.

Capriati T.,Gastroenterology Hepatology and Nutrition Unit | Francavilla R.,University of Bari | Castellaneta S.,San Paolo Hospital | Ferretti F.,Hepato Metabolic Diseases Unit | Diamanti A.,Gastroenterology Hepatology and Nutrition Unit
European Journal of Pediatrics | Year: 2015

Celiac disease (CD) is an immune-mediated systemic disorder induced by a trigger factor in genetically susceptible individuals. There is emerging evidence about the impact of the month of birth on the development of several autoimmune diseases. Our aim was to investigate whether, in Italian CD children, the season of birth is associated with development of CD later in life. We report a survey conducted at two Italian referral centers for CD in Rome and Bari. The CD database was created to enable retrospective examination of the data of all the consecutive patients, born between 2003 and 2010, who had received a diagnosis of CD. This CD patient group comprising 596 children was compared with a reference group that included all subjects born in the same period and in the same cities (439,990 controls). Overall, there was a summer birth preponderance in CD patients compared to controls (28.2 % of CD patients vs 23.0 % of the control population; OR 1.315; 95 % CI 1.100 to 1.572). Stratifying the caseload by gender and age, the summer birth preponderance was maintained for females (28.6 % CD females vs 22.6 % control females; OR 1.368; 95 % CI 1.069 to 1.750). Conclusions: our survey confirms that in Italy, children born in summer are at higher risk to develop CD than subjects born in other seasons. The identification of a responsible seasonal factor or factors, such as timing of the first introduction of gluten and/or acute viral gastrointestinal infections, would be very important for disease prevention strategies.What is Known:• Environmental factors could be involved in the pathogenesis of CD.• Data about the impact of season of birth on CD development is so far derived from North American, Northern European and Israeli surveys.What is New:• This is the first study in Southern Europe to find a relationship between season of birth (summer) and development of CD.• Summer-born infants are introduced to complementary feeding (gluten) in winter, when the rotavirus infection is at its highest peak; this may be the link between season of birth and development of CD. © 2015, Springer-Verlag Berlin Heidelberg.

Diamanti A.,Gastroenterology Hepatology and Nutrition Unit | Capriati T.,Gastroenterology Hepatology and Nutrition Unit | Capriati T.,University of Bari | Basso M.S.,Gastroenterology Hepatology and Nutrition Unit | And 5 more authors.
Nutrients | Year: 2014

The clinical presentation of celiac disease in children is very variable and differs with age. The prevalence of atypical presentations of celiac disease has increased over the past 2 decades. Several studies in adults and children with celiac disease indicate that obesity/overweight at disease onset is not unusual. In addition, there is a trend towards the development of overweight/obesity in celiac patients who strictly comply with a gluten-free diet. However, the pathogenesis and clinical implications of the coexistence of classic malabsorption (e.g., celiac disease) and overweight/obesity remain unclear. This review investigated the causes and main clinical factors associated with overweight/obesity at the diagnosis of celiac disease and clarified whether gluten withdrawal affects the current trends of the nutritional status of celiac disease patients. © 2014 by the authors; licensee MDPI, Basel, Switzerland.

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