The following is a summary of “Gluten Immunogenic Peptides Are Not Correlated With Reported Adherence to Gluten-Free Diet in Children With Celiac Disease,” published in the August 2023 issue of Endocrinology & Metabolism by Guz-Mark, et al.
The absence of a definitive standard for evaluating adherence to a gluten-free diet (GFD) in patients with celiac disease (CeD) has prompted the exploration of innovative methods such as detecting gluten immunogenic peptides (GIPs) in urine and stool. For a study, researchers sought to investigate the presence of GIPs in pediatric patients with CeD and compare the outcomes with alternative approaches for assessing GFD adherence.
Between November 2018 and January 2021, a prospective study was conducted involving pediatric patients diagnosed with CeD who had been on a GFD for at least one year. During study visits, participants underwent clinical evaluations, dietitian interviews, Biagi scoring, completion of food questionnaires, anthropometric measurements, laboratory tests, and urine and stool sample collection for GIP analysis.
About 74 patients (63.5% females) were enrolled, with a median age of 9.9 years (interquartile range, IQR: 7.8–11.7) and a median duration on GFD of 2.5 years (IQR: 2–5.5). A favorable GFD adherence, as indicated by the Biagi score, was observed in 93.1% of cases. GIP analysis was performed during 134 visits, revealing GIP presence in 27 out of 134 (20.1%): 16.3% in stool samples and 5.3% in urine samples. Males exhibited significantly higher rates of positive GIP results than females (30.6% vs. 14.1%, respectively, P < 0.05). The detection of positive GIP was not correlated with dietary assessments of GFD adherence, results of celiac serology tests, or reported symptoms.
Stool and urine GIPs can be detected in pediatric patients with CeD, even in cases where dietary assessments indicate satisfactory adherence to GFD. The utility of GIP testing in clinical practice warranted further investigation.
Source: journals.lww.com/jpgn/Abstract/2023/08000/Gluten_Immunogenic_Peptides_Are_Not_Correlated.21.aspx
