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Celiac.com 03/03/2017 - Previous studies have shown us that men are generally less troubled living with celiac disease than are women, but most studies of men with celiac disease have been mostly quantitative, and have a bio-medical emphasis. A team of researchers recently set out to explore the social experience of young men with screening-detected celiac disease and to highlight daily life situations five years after diagnosis. The research team included Ethel Kautto, Cecilia Olsson, Anneli Ivarsson, Phil Lyon, Agneta Hörnell, and Lena Alex. They are variously affiliated with the Department of Food and Nutrition and Umeå Center for Gender Studies, Umeå University, Sweden, the Department of Food and Nutrition, Umeå University, Sweden, the Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Sweden, the School of Arts, Social Sciences and Management at Queen Margaret University, UK, and the Department of Nursing at Umeå University in Sweden. Using a large Swedish school-based celiac screening-study, the team arranged to interview seven young men, all of whom were diagnosed with celiac disease at 13 years-old. The semi-structured interviews were analyzed from a gender perspective which resulted in three themes. Those themes were of young adult men being subjected to changes, striving for normality and emphasizing commitment. Many of young men reported dissociating themselves from being seen as a person with a life-long chronic disease. The analysis also showed that the young men’s daily experiences of living with celiac disease largely depended on their use of characteristics known to be associated with masculinity: such as being self-assured, demanding, and behaving authoritatively. In food situations, where the young men had the ability to make use of such characteristics in their informal group, they experienced fewer negative aspects of the disease. If the young men did not hold a strong position in their informal group, their situation was insecure and vulnerable and this could lead to avoidance of contacts and social meal situations. So, basically, being relaxed and socially confident about eating gluten-free helps to ensure success with the diet. Source: International Journal of Celiac Disease Vol. 4, No. 4, 2016, pp 138-145. doi: 10.12691/ijcd-4-4-7 -
Celiac.com 09/07/2016 - Sometimes individual medical cases that initially puzzle doctors can yield new revelations for doctors and patients, and sometimes point to new directions for inquiry. The case of a young woman whose serious heart problems led doctors to discover a that she suffered from celiac disease is just the latest example. The research team included Mariam Ghozzi, Chaima Mrizak, Taha Hasnaoui, Sonia Ernez, Maha Kacem, Asma Ommezzine, Laarbi Chaieb, Gouider Jridi, and Ibtissem Ghedira. They are variously affiliated with the Department of Cardiology, the Department of Endocrinology, and the Department of Immunology at Farhat Hached University Hospital in Sousse, Tunisia, with the Department of Biochemistry at Sahloul University Hospital in Sousse, Tunisia, and with the Research Unit (03/UR/07-02) of the Faculty of Pharmacy at Monastir University in Tunisia. The 18-year-old girl was admitted for tachycardia and dyspnea of effort stage II of NYHA. Her medical history revealed a stroke four months prior, along with uncontrolled type 1 diabetes since the age of 10 years. Physical examination showed a short stature, pallor, muscular atrophy and delayed puberty, but no diabetic neuropathy. By interviewing the patient, doctors found that she had shown signs of celiac disease since early infancy, and secondary amenorrhea for two years. Ophtalmological examination showed no diabetic retinopathy. Echocardiography showed the presence of a big thrombus, hypokinesis and dilated cardiomyopathy with a low rate of left ventricular ejection fraction at 20%. Laboratory tests revealed a high level of B-type natriuretic peptide, anemia, vitamin D deficiency, hypocholesterolemia and low level of high density lipoprotein (HDL). Microalbuminuria was negative. All serological markers of celiac disease were highly positive. The patient was put on gluten-free diet and she received a re-synchronization cardiac therapy. We emphasize that celiac disease and type 1 diabetes must be kept in mind in etiological diagnosis of dilated cardiomyopathy. Source: Case Report Journal of Gastroenterology, Pancreatology & Liver Disorders -
Celiac.com 08/10/2016 - Low HDL cholesterol (HDL-C) concentrations have long been tied to increased cardiovascular risk. People with type 1 diabetes (T1D) who presented complications (1) and people with untreated celiac disease also have low HDL-C levels. People with both TID and celiac disease might face a sharper lipid abnormalities and a more aggressive the atherosclerotic process. Can a gluten-free diet reverse that process? A team of researchers recently set out to examine the effects of a gluten-free diet lipid on profiles of patients with Type 1 diabetes. They study was conducted on behalf of the for the Diabetes Study Group of the Italian Society of Pediatric Endocrinology and Diabetology (ISPED). The research team included Silvana Salardi, Giulio Maltoni, Stefano Zucchini, Dario Iafusco, Santino Confetto, Angela Zanfardino, Sonia Toni, Barbara Piccini, Maximiliano Zioutas, Marco Marigliano, Vittoria Cauvin, Roberto Franceschi, Ivana Rabbone, Barbara Predieri, Riccardo Schiaffini, Alessandro Salvatoni, Petra Reinstadler, Giulia Berioli,Valentino Cherubini and Giuseppe d'Annunzio. They are variously affiliated with the Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy, the Department of Pediatrics, Second University of Naples, Naples, Italy, the Meyer Children's Hospital, University of Florence, Florence, Italy, the Regional Center for Pediatric Diabetes, Clinical Nutrition & Obesity, Department of Life & Reproduction Sciences, University of Verona, Verona, Italy, the Pediatric Unit, S. Chiara Hospital, Trento, Italy, the Department of Pediatrics, University of Turin, Turin, Italy, the Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy, the Endocrinology and Diabetes Palidoro Unit at the University Department of Pediatric Medicine, Bambino Gesu Children's Hospital, IRCCS, Rome, Italy, the Pediatric Clinic, Insubria University, Varese, Italy, the Department of Pediatrics, Regional Hospital, Bolzano, Italy, the Department of Gynaecological, Obstetric and Paediatric Sciences at the University of Perugia in Perugia, Italy, the Division of Paediatric Diabetes in Children and Adolescents, Maternal-Infantile Department, Salesi Hospital, Ancona, Italy, and with the Department of Pediatrics, IRCCS Gaslini Children's Hospital at the University of Genova in Genova, Italy. From 13 centers within the Italian Society of Pediatric Endocrinology and Diabetology (ISPED), the team collected data on a large number of children with both T1D and concurrent biopsy-proven celiac disease. They collected data at the time they initiated a gluten-free diet, and again after 1 year of a gluten-free diet. They verified gluten-free status using serum tests for celiac disease-related antibodies. They enrolled 201 children with T1D diagnosed at age of 5.8 +/- 3.8 years, and celiac disease diagnosed at age of 7.5 +/- 4.5 years. To compensate for any metabolic derangement at diabetes onset, they included only cases in which celiac disease diagnosis was made at least 3 months after that of T1D. As a control group, they used 224 patients with T1D only, matched by age, sex, diabetes duration, and HbA1c. Before subjects began a gluten-free diet, the team found that HDL-C values were significantly lower in children with celiac disease and T1D than in the control group, with the greatest decrease found in younger children aged, 6 years. Subjects with HDL-C values below pediatric percentile cutoffs for sex and age were younger than those with normal values (6.2 +/- 4.4 vs. 8.6 +/- 4.3 years, P , 0.0001) and also had lower HbA1c (7.5 +/- 0.8 vs. 8.0 +/- 1.5%, P , 0.005). After a gluten-free diet the average values of HDL-C in the total study population rose sharply to 60.9 +/- 13.7, compared with 51.3 +/- 13.6 mg/dL (P , 0.0001), and returned to normal. The percentage of subjects with HDL-C values lower than pediatric percentile cut points fell significantly (P , 0.0001) from 42 to 16%. Subjects with complete adherence to gluten-free diet showed the most significant improvement of HDL-C, and subjects with partial adherence showed a lower, but significant, improvement of HDL-C. These results dovetail with other data from the past few years, but more clearly indicated the reduction in HDL-C at diagnosis, and the better recovery with a gluten-free diet. The researchers view the reduction HDL-C either as a proxy marker for intestinal inflammation, or as the result of a change in the intestinal secretion of apolipoprotein AI (5), the major HDL structural protein. This change is seen most sharply in the youngest children, who probably suffer more severely, as indicated by signs of malabsorption, e.g., lower HDL-C and HbA1c levels. Children with T1D and untreated celiac disease, especially young children, typically show an unfavorable lipid profile, i.e., low HDL-C values. Following a gluten-free diet normalizes HDL-C levels, with the greatest benefits can be seen in individuals who follow the diet strictly, and in the youngest individuals. Because of the possibility of increased risk of cardiovascular disease, a strict gluten-free diet is mandatory in these children. Source: Diabetes Care. DOI: 10.2337/dc16-0717
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Celiac.com 07/25/2013 - Numerous studies have shown that people with immune-mediated disorders can suffer from accelerated progression of atherosclerosis and increased cardiovascular risk, but few studies have been done for people with celiac disease. A team of researchers recently looked at young adults with celiac disease to see what, if any, added risk they may have for developing atherosclerosis. The research team included S. De Marchi, G. Chiarioni, M. Prior, and E. Arosio. They are variously affiliated with the Department of Medicine,and the Division of Vascular Rehabilitation in the Department of Medicine at the University of Verona in Verona, Italy, and with the Division of Gastroenterology and Hepatology, Center for Functional GI and Motility Disorders at the University of North Carolina in Chapel Hill, North Carolina. The team wanted to assess instrumental and biochemical signs of atherosclerosis risk in 20 adults at first diagnosis of celiac disease and again after 6–8 months of gluten-free diet with mucosal recovery. They used twenty-two healthy members of the hospital staff as matched controls. For their study, the team analyzed total, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triglycerides, homocysteine, C-reactive protein, folate and vitamin B12. They also conducted ultrasound measurement of carotid intima-media thickness (IMT) and endothelium-dependent dilatation at diagnosis and after gluten withdrawal. The team found average total and HDL-cholesterol (HDL-C) to be within the normal range, at baseline, while average LDL-cholesterol concentration was slightly higher. Diet was tied to increment in total and HDL-C (68.2 ± 17.4 vs. 51.4 ± 18.6 mg/dL; P < 0.001). Meanwhile, total/HDL-C ratio was substantially improved (3.05 ± 0.71 vs. 3.77 ± 0.92; P < 0.02). Overall plasma homocysteine was elevated and not changed by diet, while C-reactive protein dropped significantly with diet (1.073 ± 0.51 vs. 1.92 ± 1.38 mg/dL; P < 0.05). At baseline, celiacs showed increased IMT (0.082 ± 0.011 vs. 0.058 ± 0.012 cm; P < 0.005), with decreased endothelium-dependent dilatation (9.3 ± 1.3 vs. 11.2 ± 1.2%; P < 0.05). A gluten-free diet returned both of those factors to normal. According to these results, vascular impairment and unfavorable biochemical risk pattern increase the potential for young adults with celiac disease to develop early atherosclerosis. This increased risk may be largely due to chronic inflammation. The good news is that adopting a gluten-free diet seems to return the body to a healthy mucosal state and returns the body to the normal risk levels of a healthy non-celiac person. Source: Alimentary Pharmacology & Therapeutics - Volume 38, Issue 2, pages 162–169, July 2013. DOI: 10.1111/apt.12360 -
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Celiac.com 06/06/2012 - Celiac disease is an autoimmune disease caused by a reaction to the component of wheat, barley, and rye called gluten and can affect the entire body. Dermatitis herpetiformis (DH) is a blistering and extremely itchy skin rash. It’s usually symmetrical in shape and is most commonly located on the elbows, knees, buttocks, and upper back. It’s common for people with DH to have rashes appear in the same spot, and they can either be consistent or come and go. It is hard enough being a young adult, having celiac disease is the icing on the cake, and having Dermatitis Herpetiformis is the cherry on top. So how is it that I have been able to so easily make the transition from eating gluten on a daily basis to being 100% gluten-free for over six years now? Simple: by getting educated. When I was first diagnosed it was very hard for me. I didn’t know what had gluten in it, what body products to use, etc. My mother Tina Turbin, founder of GlutenFreeHelp.info, gave me some great advice. She told me to do my own research. So I set off to get a real understanding of celiac disease and DH. I was going to have to live with them both my whole life so I felt it couldn’t hurt knowing more about them. This was the best advice anyone could have ever given me. With the broad knowledge of celiac disease and DH available these days, I was able to read so much information and get a real grasp of the subjects. I finally was able to easily know which products would have gluten in them and what the gluten actually did internally to my body. I really made being gluten-free a priority in my life. I made sure this priority was known among my family and friends as well. They all were more than willing to help. Now, whether going out for brunch with friends or traveling, the people I surround myself with are always picking places where I will have an easy time following my gluten-free diet. Just yesterday, a friend of mine let me know she picked a place for us to eat that would prepare any of their pasta dishes with gluten-free pasta. So, my advice to you is this: First, do your own research. There are so many people out there with great advice and so much information to share. The more we join up with others, the easier it will be. Secondly, inform the people you are surrounded with of your dietary needs. Too many people think being gluten-free is just a fad when in reality celiac disease and DH are extremely important and should not be made fun of. Last, enjoy life. Living gluten-free can actually be quite fun. The food is delicious and the health benefits are outstanding. Being gluten-free doesn’t have to cause you stress. In fact, by following these guidelines, gluten-free living can become quite rewarding. -
Celiac.com 03/12/2010 - A team of researchers recently noted similar presentations of celiac disease in both elder and younger patients.The research team included Rupa Mukherjee, Ikenna Egbuna, Pardeep Brar, Lincoln Hernandez, Donald J. McMahon, Elizabeth J. Shane, Govind Bhagat, and Peter H. R. Green. They are affiliated variously with the Division of Digestive and Liver Diseases, the Division of Endocrinology, Department of Medicine, and the Department of Pathology at the Columbia University College of Physicians and Surgeons in New York, and with Columbia University Medical Center's Celiac Disease Center. It is well known that celiac disease can affect individuals of all ages. However, there have been few studies to focus solely on how celiac disease presents among elderly people. To get a better understanding of how celiac disease presents in the elderly, a research team recently set out to compare aspects of celiac disease from elderly populations with a population of young adults with celiac disease. The first step was to assemble two groups of patients, an elderly cohort over 65-years old, and a young adult cohort aged 18–30 years, with biopsy-confirmed celiac disease. They did this by reviewing a tertiary center database of celiac disease patients with celiac disease, which provided data on symptom duration, clinical presentation, small intestinal pathology, associated conditions, and the presence of bone disease. The team reviewed data on 149 young adult and 125 elderly patients with celiac disease; The elderly subjects comprised 12.4% of the patient database. Both groups showed similar duration of symptoms before diagnosis, with young adults at 5.8 ± 12 years and elderly at 6.14 ± 12.6 years, respectively (p = 0.119). The presenting symptoms were also basically the same for both groups, with diarrhea being the main presenting symptom in 49% of young adults and 50% of the elderly (p = 0.921). Both groups showed similar rates of autoimmune disease, with 19% of young adult and 26% of elderly patients having relevant autoimmune conditions (p = 0.133). Both groups showed similar presence of villous atrophy and rates of bone disease, while the elderly group showed higher rates of thyroid disease and neuropathy (p = 0.037 and p = 0.023, respectively). The team expressed surprise that, both clinically and histologically, celiac disease seems to present similarly in elderly and young adult patients. They note that since the exact causes for celiac disease at any given age remain unclear and warrant further study. Source: Dig Dis Sci DOI 10.1007/s10620-010-1142-4.
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