سامانه کنگره های دانشگاه علوم پزشکی و خدمات بهداشتی و درمانی آذربایجان غربی

صفحه اصلی / بیستمین همایش سالیانه بیماری های شایع گوارش و کبد کودکان ایران و دومین همایش بین المللی چاقی کودکان

The Impact of Early Diagnosis and Gluten-Free Diet on Pediatric Celiac Disease Outcomes: A Prospective Cohort Study (2020–2023)

نویسندگان :

Aydin Mahmoud Alilou¹ Roghayeh Faraji Akhijahani² Parinaz Mahmoud Alilou³ Pardis Pour Ali⁴ Pouria Shieeh⁵ Alisan Khodayarlo⁶ Sina Manouchehrnia⁷ Sana Nasirpour⁸ Meysam Najafi⁹

1- دانشگاه علوم پزشکی تبریز 2- دانشگاه علوم پزشکی تبریز 3- دانشگاه علوم پزشکی تبریز 4- دانشگاه علوم پزشکی تبریز 5- دانشگاه علوم پزشکی تبریز 6- دانشگاه علوم پزشکی تبریز 7- دانشگاه علوم پزشکی تبریز 8- دانشگاه علوم پزشکی تبریز 9- دانشگاه علوم پزشکی تبریز

کلمات کلیدی :

Celiac Disease،Gluten-Free Diet،Pediatrics،Early Diagnosis،Growth Parameters،Serological Testing،Adherence،Nutritional Outcomes،Mucosal Healing،Dietary Compliance

چکیده :

Background and Aim: Celiac disease (CD), an autoimmune disorder triggered by gluten ingestion, affects 1–2% of children globally. Delayed diagnosis exacerbates complications such as growth failure, anemia, and osteoporosis. This study evaluates the clinical benefits of early serological screening and strict gluten-free diet (GFD) adherence in pediatric CD patients. Methods: A prospective cohort of 132 children (ages 2–16 years) diagnosed with CD at a tertiary pediatric nutrition clinic (2020–2023) was enrolled. Early diagnosis was defined as confirmation via IgA tissue transglutaminase (tTG) and endomysial antibody (EMA) testing within 6 months of symptom onset. Participants were stratified into early (n=78) and delayed (n=54) diagnosis groups. Outcomes included growth parameters (height-for-age Z-scores, BMI), symptom resolution, and GFD adherence assessed via serology and dietary logs. Data were analyzed using SPSS v27 and R, with significance at p < 0.05. Results: Early diagnosis correlated with significant improvements in height-for-age Z-scores (+1.2 vs. +0.4 in delayed group, p = 0.001) and BMI normalization (89% vs. 61%, p = 0.002). Symptom resolution (e.g., diarrhea, fatigue) occurred 40% faster in the early group (p = 0.01). Strict GFD adherence (≥90% compliance) was higher in early-diagnosed children (82% vs. 56%, p = 0.003). Seronegativity (tTG < 10 U/mL) was achieved in 76% of early-diagnosed patients versus 44% (p = 0.001). Delayed diagnosis was associated with persistent villous atrophy on follow-up biopsies (OR: 3.1, 95% CI: 1.4–6.9). Conclusion: Early serological screening and GFD initiation markedly enhance growth, symptom control, and mucosal healing in pediatric CD. Institutional protocols prioritizing rapid testing and dietitian-led adherence programs are critical to mitigate long-term complications.