Gastroenterol Res Pract. 2020 Mar 27;2020:6138243. doi: 10.1155/2020/6138243.eCollection 2020.

Anna Rybak ¹, Aldona Wierzbicka ², Piotr Socha ³, Anna Stolarczyk ³, Bozena Cukrowska ⁴, Lukasz Obrycki ⁵, Zbigniew Wawer ², Roman Janas ², Beata Oralewska ², Anna Szaflarska-Poplawska ⁶, Barbara Iwanczak ⁷, Elzbieta Cyrta-Jarocka ⁸, Urszula Grzybowska-Chlebowczyk ⁹, Wojciech Cichy ¹⁰, Grazyna Czaja-Bulsa ¹¹, Jerzy Socha ³

Author information

• ¹Department of Gastroenterology, The Great Ormond Street Hospital, London, UK.
• ²Department of Biochemistry and Experimental Medicine, Children's Memorial Health Institute, Warsaw, Poland.
• ³Department of Gastroenterology, Hepatology and Feeding Disorders, Children's Memorial Health Institute, Warsaw, Poland.
• ⁴Department of Pathology, Children's Memorial Health Institute, Warsaw, Poland.
• ⁵Department of Nephrology, Kidney Transplantation and Arterial Hypertension, The Children's Memorial Health Institute, Warsaw, Poland.
• ⁶Department of Pediatrics, Allergology and Gastroenterology, Collegium Medicum Nicolaus Copernicus University, Bydgoszcz, Poland.
• ⁷Department of Pediatrics, Gastroenterology and Nutrition, Medical University of Wroclaw, Wroclaw, Poland.
• ⁸Department of Pediatrics, Gastroenterology and Allergology, Medical University, Bialystok, Poland.
• ⁹Department of Gastroenterology, Department of Pediatrics, Upper-Silesia Center of Children's Health, Katowice, Poland.
• ¹⁰Department of Pediatrics, Gastroenterology and Metabolic Diseases, University of Medical Sciences, Poznan, Poland.
• ¹¹Department of Pediatrics, Gastroenterology and Rheumatology, Independent Specialist Public Health Care, Szczecin, Poland.

Abstract

Results: We found significantly lower concentrations of total cholesterol, lipoprotein LDL-C, apolipoproteins A1 and B, as well as hCRP in all children with CD. We showed decreased level (<5 ng/mL) of folic acid among 46% of children treated for >5 years. Moreover, we showed significant decrease of folic acid level already after 1 year of a GFD (12 vs. 5.6 ng/mL; p < 0.001). We also found significant negative correlation of z-score body mass index (BMI) with HDL and APOA1 level (r = -0.33; p = 0.015 and r = -0.28; p = 0.038, respectively) and modest positive correlation of z-score BMI with atherogenic factor of total cholesterol-HDL ratio and LDL-HDL ratio (r = 0.40; p = 0.002 and r = 0.36; p = 0.006, respectively). Analysis of physical activity showed an increase in the insulin levels with inactivity (r = 0.36; p = 0.0025). We also found positive correlation of the sleep duration with the adiponectin level (r = 0.41; p = 0.011).

Conclusions: In children with CD treated with a GFD, decreased level of folic acid together with increased BMI, sedentary behavior, and an improper lipid profile may predispose them to atherosclerosis in the long run. This data suggests the need of further studies to determine the need for metabolic cardiovascular risk screening in children with CD.