We evaluated the effect of GFD on the growth of children with the classical form of CD on long-term GFD (> 2 years).
Methods: We studied growth parameters (weight gain/day, BMI and BMISDS, HtSDS) and lab data for 30 prepubertal children aged 8.5 years +/−3 years with CD, who were on GFD since the age of 3.4 years +/−2.6 years (> 2 years on GFD) for duration of 1 year. The anthropometric data of 30 randomly selected normal, age and sex-matched, children were used as a control.
Results: The weight gain per day was average or above average for age and sex in 27 children and below average in 3. Two out of those 3 children had slow linear growth (decreased HtSDS by -0.56 and -0.1 over one year). BMISDS was normal in 26 /30 patients (> -1.5). BMI SD changed from −0.36 +/−1.1 to −0.33 +/−1.1 during the year of treatment. BMISDS decreased in 9 children during the follow up period that can be explained by their fast-linear growth (increased HtSDS) in seven of them. The HTSDS was < −2 in four out of the 30 children at the beginning of F/U and in 2 children after a year of F/U (catch up in two), HTSDS remained normal or increased in 28/30 children during the year of treatment (−0.38 +/−1.2 to −0.22 +/−1.1), a positive trend = 0.15 +/−0.4 SD. Only one patient crossed down 1 major height centiles during the year of follow up, with low weight gain/day and decreased BMISDS that can be explained by incompliance with the GFD. HtSDS and BMISDS increased significantly in the CD group versus controls during the year of follow-up. All patients had normal serum albumin, liver enzyme and hemoglobin levels. 33.3 % of patients had low Ferritin level and 33.3% Had Vitamin D deficiency.
Discussion: Most of our children with CD grew normally both in height and weight on GFD. Catch-up growth still occurs in some of them after 2 years of being on GFD. All had normal Hb and albumin level. Those with low BMISDS and/or HtSDS need further management including reinforcement on following strictly the GFD and investigating other factors that might affect growth pattern
Conclusion: Catchup growth continues in some children with CD on GFD even after 2 years of being on GFD. Measuring weight gain /day is a sensitive indicator for monitoring growth in these children.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology