Metabolic syndrome in patients with coeliac disease on a gluten-free diet

BackgroundSeveral studies have shown that weight changes are common in patients with coeliac disease after starting a gluten-free diet (GFD), but data on the prevalence of metabolic syndrome in this population are still scarce. AimsTo assess the prevalence of metabolic syndrome in patients with CD at diagnosis and 1year after starting GFD. MethodsWe enrolled all consecutive patients with newly diagnosed coeliac disease (CD) who were referred to our third-level CD Unit. For all patients we collected: waist circumference, BMI, blood pressure, lipid profile (HDL cholesterol, triglycerides) and levels of blood glucose. Diagnosis of metabolic syndrome was made according to the International Diabetes Federation (IDF) criteria for European countries. The prevalence of metabolic syndrome was re-assessed after 12months of GFD. ResultsNinety-eight patients with CD were assessed, two patients with CD (2%) fulfilled the diagnostic criteria for metabolic syndrome at diagnosis and 29 patients (29.5%) after 12months of GFD (P<0.01; OR: 20). With regard to metabolic syndrome sub-categories 1year after GFD compared to baseline respectively: 72 vs. 48 patients exceeded waist circumference cut-off (P<0.01; OR: 2.8); 18 vs. 4 patients had high blood pressure (P<0.01; OR: 5.2); 25 vs. 7 patients exceeded glycemic threshold (P=0.01; OR: 4.4); 34 vs. 32 patients with CD had reduced levels of HDL cholesterol (P=0.7); and 16 vs. 7 patients had high levels of triglycerides (P=0.05). ConclusionsPatients with coeliac disease show a high risk of metabolic syndrome 1year after starting a gluten-free diet. We suggest that an in-depth nutritional assessment is undertaken for all patients with coeliac disease.