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Objective: Celiac disease (CD) is a chronic immune-mediated disorder characterized by growth retardation and malabsorbtion related to mucosal damage and inflammation of small intestine in genetically predisposed people as a result of gluten exposure. In CD treatment, clinical, histological and serological improvement is possible with gluten-free diet. Thus, we aimed to assess the vitamin and trace element levels of CD patients in regard to their compliance with gluten-free diet. Methods: In our study, 77 patients diagnosed with CD were evaluated retrospectively. All cases were assessed with Marsh classification histopathologically and surveyed when they follow a gluten-free diet. Demographic features, age of disease onset, physical examination findings, anthropometric measurements and laboratory findings along with clinical and laboratory outcomes of patients after a gluten-free diet were compared between compliant to diet and non-compliant to diet groups. Results: A total of 77 cases consisting of 48 females and 29 males with a diagnosis of CD and mean age of 9,81 ± 4,73 years on admission were reqruited in our study. Patients were mostly found to be Marsh type 3a (n = 22) and Marsh type 3b (n = 20) histopathologically. The results of serological screening revealed that 40,3% of cases (n = 31) were compliant with diet whereas 59,7% (n = 46) non-compliant. Non-compliant group had significantly lower mean vitamin B12, vitamin D, folate, zinc and selenium levels compared to compliant group (p values = 0.000, 0.000, 0.000, 0.000 and 0.031, respectively). In addition, a significantly higher mean serum total IgA level was detected in non-compliant group in comparison to compliant group (p = 0,027). Conclusion: In our study, high efficacy of gluten-free diet (GFD) in correcting nutritional insufficiencies and deficiencies was shown. Thus, there is no doubt that informing patients and their families about lifelong GFD in detail is beneficial although GFD treatment contains many social and practical difficulties.

Impact of compliance to a gluten-free diet on vitamin and trace element deficiencies in celiac patients