The effect of gluten-free diet on mean platelet volume levels as a short-term follow up biomarker in biopsy proven celiac disease patients and its comparison with IgA-tissue transglutaminase antibody levels
DOI:
https://doi.org/10.18203/2349-3291.ijcp20231843Keywords:
Autoimmunity, Celiac disease, Gluten-free diet, MPVAbstract
Background: Celiac disease is an autoimmune disease for which there is a known environmental trigger i.e., gluten. Adherence to gluten-free diet is the mainstay of treatment.
Methods: This observational prospective study was conducted in the Department of Paediatrics, SP Medical College, Bikaner between August 2020 to August 2021. Newly diagnosed celiac disease patients below 14 years of age were included in the study excluding patients with any associated co-morbid conditions like Diabetes, Hypertension and Hypothyroidism. IgA-tTG titre and complete blood counts were performed at the time of diagnosis, and repeated after 3 months of strict gluten-free diet. The collected data were coded, tabulated and analysed. P values < 0.05 were statistically significant.
Results: The mean IgA-tTG decreased from 116.28 at the time of diagnosis to 50.98 after 3 months of the gluten-free diet (p = <0.001). Also, the mean MPV decreased from 9.58 to 9.19 and the change was statistically significant (p = 0.032). When two biomarkers i.e., MPV and IgA-tTG were compared as being better biomarkers for the gluten-free diet, a weak positive correlation was observed but was not statistically significant (p = 0.212).
Conclusions: This study showed that Mean Platelet Volume (MPV) levels can be used as a short-term biomarker to check adherence to the gluten-free diet.
References
Elli L, Branchi F, Tomba C, Villalta D, Norsa L, Ferretti F. Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity. World J Gastroenterol. 2015;21:7110-9.
Jeon MK, Klaus C, Kaemmerer E, Gassler N: Intestinal barrier: Molecular pathways and modifiers. World J Gastrointest Pathophysiol. 2013;4:94-9.
Ludvigsson JF, Leffler DA, Bai JC, Biagi F, Fasano A, Green PH, et al.: The Oslo definitions for coeliac disease and related terms. Gut. 2013;62(1):43-52.
Troncone R, Jabri B: Coeliac disease and gluten sensitivity. J Intern Med. 2011;269:582-90.
Pré MF, Sollid LM. T-cell and B-cell immunity in celiac disease. Best Pract Res Clin Gastroenterol. 2015;29(3):413-23.
Akirov A, Pinhas-Hamiel O. Co-occurrence of type 1 diabetes mellitus and celiac disease. World J Diabetes. 2015;6(5):707-14.
Pinier M, Fuhrmann G, Verdu EF, Leroux JC. Prevention measures and exploratory pharmacological treatments of celiac disease. Am J Gastroenterol. 2010;105(12):2551-61.
Dicke WK, Weijers HA, van de Kamer JH: Coeliac disease. II. The presence in wheat of a factor having a deleterious effect in cases of coeliac disease. Acta Paediatr (Stockh). 1953;42(1):34-42.
Van de Kamer JH, Weijers HA, Dicke WK. Coeliac disease. IV. An investigation into the injurious constituents of wheat in connection with their action on patients with coeliac disease. Acta Paediatr. 1953;42:223-31.
Moulton ALC. The place of oats in the coeliac diet. Arch Dis Child. 1959;34(173):51-5.
Anderson CM, Gracey M, Burke V: Coeliac disease: some still controversial aspects. Arch Dis Child. 1972; 47(252):292-8.
Hassan K, Kader H. Celiac disease: the search for adjunctive or alternative therapies. Expert Rev Gastroenterol Hepatol. 2014;8(3):313-21.
Plugis NM, Khosla C. Therapeutic approaches for celiac disease. Best Pract Res Clin Gastroenterol. 2015;29(3):503-21.
Pietzak MM. Follow-up of patients with celiac disease: achieving compliance with treatment. Gastroenterology. 2005;128(4):135-41.
Ceylan Y, Kumanlioglu K, Oral A, Ertan Y, Ozcan Z. The correlation of clinicopathological findings and neutrophil- tolymphocyte and platelet-to- lymphocyte ratios in papillary thyroid carcinoma. Mol Imaging Radionucl Ther. 2019;28:15-20.
Kapsoritakis AN, Koukourakis MI, Sfiridaki A, Potamianos SP, Kosmadaki MG, Koutroubakis IE, et al.: Mean platelet volume: a useful marker of inflammatory bowel disease activity. Am J Gastroenterol. 2001;96(3):776-81.
Danese S, Motte Cd Cde L, Fiocchi C. Platelets in inflammatory bowel disease: clinical, pathogenic, and therapeutic implications. Am J Gastroenterol. 2004;99(5):938-45.
Kisacik B, Tufan A, Kalyoncu U, Karadag O, Akdogan A, Ozturk MA. Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine. 2008;75(3):291-4.
Poddar U, Thapa BR, Singh K. Clinical features of celiac disease in Indian children: are they different from the West? J Pediatr Gastroenterol Nutr. 2006;43(3):313-7.
Purnak T, Efe C, Yuksel O, Beyazit Y, Ozaslan E, Altiparmak E. Mean platelet volume could be a promising biomarker to monitor dietary compliance in celiac disease. Ups J Med Sci. 2011;116(3):208-11.
Bolat AD. Can serum mean platelet volume be used as an inflammatory biomarker in patients of celiac disease. Akademik Gastroenterology Dergisi. 2018;17(2):62-5.
Ramachandran M, Agarwal A, Ravi RNM, Rajeshwari K, Lomash A, et al. Mean platelet volume as short-term follow-up biomarker in children with celiac disease. Indian J Child Health. 2017;4(4):515-7.
Annibale B, Severi C, Chistolini A, Antonelli G, Lahner E, Marcheggiano A, et al. Efficacy of gluten-free diet alone on recovery from iron deficiency anaemia in adult celiac patients. Am J Gastroenterol. 1996;7:132-7.
