Relationship between malnutrition and sarcopenia in patients with celiac disease

INTRODUCTION AND AIM. Celiac disease (CD) is an autoimmune and familial disease that develops in genetically susceptible individuals as a result of sensitivity to gluten in cereal and cereal products, causes characteristic lesions and malabsorption in the small intestine, and shows clinical improvement with gluten-free diet. In classical CD form untreated patients are at high risk of malnutrition, but deterioration of nutritional status is frequently reported in patients with subclinical form of the disease. Sarcopenia is a syndrome that is accompanied by a general and progressive loss of skeletal muscle mass and strength, causing negative consequences such as physical impairment, low quality of life and death. One of the secondary causes of sarcopenia is malnutrition. In our study, we aimed to evaluate the frequency of malnutrition and sarcopenia and the relationship between malnutrition and sarcopenia in adult CD patients. MATERIAL AND METHOD. The study included 119 celiac patients between the ages of 18-65 and 119 individuals between the ages of 18-65 with dyspeptic complaints, without chronic disease and CD who were admitted to the gastroenterology outpatient clinic of Gaziantep University Medical Faculty Hospital between 01.10.2019-31.12.2019. Routine complete blood tests, biochemical parameters, MUST (Malnutrition Universal Screening Tool) scoring, anthropometric measurements, hand dynamometer and walking speed and bioimpedance analysis were evaluated retrospectively. SPSS 22 windows version was used for analysis. P<0.05 value was considered statistically significant. The cut-off value of -2 SD below the reference group was determined. RESULTS. In the celiac group, the mean muscle mass (p = 0.004), skeletal muscle mass index (p = 0.011) and skin thickness (p = 0.001) of the patients were found to be statistically significantly lower than the control group. When compared to the CD group, the MUST score was found to be statistically significantly lower in all individuals in the control group (p <0.001). Sarcopenia was not detected in the control group. In the CD group, 24.4% of the patients were evaluated as possible sarcopenic, 14.3% as class 1 sarcopenic and 20.2% as class 2 sarcopenic. In our study, there was no statistically significant relationship between sarcopenia and MUST score (p> 0.05). The frequency of sarcopenia was found to be statistically higher in patients with active celiac disease compared to patients in remission (p = 0.009). CONCLUSION. Malnutrition and sarcopenia are more common in celiac disease than in the normal population. The incidence of sarcopenia is higher, especially in individuals with active disease. We did not find a relationship between malnutrition and sarcopenia, but we think that the underlying cause is chronic inflammation. We believe that keeping the disease under control with proper diet will reduce the risk of sarcopenia.