Indicators of physical development of children with celiac disease
Background. Given the clinical polymorphism of celiac disease, it is often undiagnosed for several years that causes the development of serious changes in nutritional status, hormonal and metabolic restructuring, growth retardation, malnutrition and deficiency. The purpose of the study is to evaluate the physical development of children and adolescents based on a comprehensive analysis of the anthropometric parameters during the clinical manifestation of celiac disease. Materials and methods. The results of a survey of 59 children and adolescents aged 6 months to 18 years with a verified diagnosis of celiac disease were analysed. Anthropometric measurements were carried out in the morning by conventional methods. The data obtained from anthropometric measurements of children were estimated by regional standards. The deviation of the body length index relative to age (SDS body length), body weight relative to body length (SDS body weight) was calculated. Statistical processing included the calculation of the arithmetic mean of each of the indicators (M), the standard deviation (s), mean error of the arithmetic mean (m), the probability of differences of the mean values by the Student t-test, p < 0.05. Results. Indicators of physical development of children with celiac disease varied significantly depending on the age of diagnosis verification and the duration of the latent period of the disease. In the structure of clinical manifestations in the patients in the acute period of celiac disease, the delay of physical development is in the first place — 84.7 % of people. In this case, 76.3 % of children have a reported body mass deficit, of which grade I body mass deficit is in 71.1 %, grade II body weight deficit is in 22.2 %, and grade III body weight deficit is in 6.7 % of cases. Growth retardation was found in 52.5 % of children: somatogenic dwarfism was detected in 10.1 % of patients and low growth in 42.3 % of children. Assessment of the atrophy stage according to the Marsh-Oberhuber classification showed that the children with a more severe form of body weight deficit were diagnosed with Marsh 3C type, whereas with a slight lag in body mass indicators, the types of Marsh 3A and Marsh 3B were diagnosed. Conclusions. Anthropometric parameters of patients with celiac disease are inversely dependent on the duration of the latent period and the age of the disease diagnosis. In young children, body weight deficit outweighs growth retardation, whereas older children experience a slowdown in growth with the formation of stunting and somatogenic dwarfism.
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