Annals of Pediatric Gastroenterology and Hepatology ISPGHAN

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VOLUME 2 , ISSUE 3-4 ( July-Sep/Oct-Dec, 2020 ) > List of Articles

Gastroenterology Award Paper

Is Gluten Free Diet Deficient in Selenium? A Prospective Study in Children with Celiac Disease

A Gopan, M SenSarma, S K Yachha, A Srivastava, A Mathias, N Neelu, U Poddar

Keywords : Children, Celiac disease, Selenium, Gluten free diet

Citation Information : Gopan A, SenSarma M, Yachha S K, Srivastava A, Mathias A, Neelu N, Poddar U. Is Gluten Free Diet Deficient in Selenium? A Prospective Study in Children with Celiac Disease. Ann Pediatr Gastroenterol Hepatol 2020; 2 (3-4):13-13.

DOI: 10.5005/jp-journals-11009-0062

License: CC BY-NC 4.0

Published Online: 06-07-2022

Copyright Statement:  Copyright © 2020; The Author(s).


Wheat is a rich source of Selenium (Se). Dietary compliant celiac disease (CD) patientsin disease remission may be prone to Se deficiency and its biological effects. Aim of the study were: 1) Assess the absolute and functional deficiency of Se in gluten free diet (GFD) compliant CD children.2) Assess the sequential effect of oral Se supplementation and dietary modifications in those deficient. Asymptomatic CD children (<18 years) on compliant GFD. 3 years in serological (anti-tissue transglutaminaseantibody. 3 times upper limit normal) and mucosal (Marsh grade<2) remission were included. Elemental Se (100 μgday) for 3mo followed by Se-rich (>100 μgday) modified GFD for next 3mo was given. Dietary selenium content (3 day recall), plasma Se levels, selenoprotein- P1 (SEPP1) andglutathione peroxidase-3 (GPX-3) were estimated at baseline. Se deficiency was defined as plasma Se levels <60 μgL. Response in growth parameters, absolute and functional Selevels were reassessed at 3 and 6mo. Results: Of 77 screened, 51CD [duration of compliant GFD 6 (3-13) y; age at study enrolment 14 (4.7.18) y] children were eligible for the study. Thyroid hypofunction and impaired glucose tolerance were seen in 21 (41%) & 4 (7.8%) children on baseline endocrine screen. All 51 patients were Se-deficient [plasma Se 34.5 (19.3-53) μgL]. Baseline dietary Se content [26.7 (12-99) vs. 40.7 (6.5-94) μgd, p = 0.009], plasma Se[33.5 (19.3-45.9) vs. 34.7 (23.8-53) μgL, p = 0.4], SEPP1 [3.1 (2.2-5) vs. 3 (1.9-4.4) μgmL, p = 0.7], GPX3[7.5 (3.3-60.3) vs. 9.5 (0.6-60.6) μgmL, p = 0.3] were present in pure vegans (53%) andovo/non-vegans (47%). Ten patients with irregular follow-up were excluded. Significant increase from baseline to 3mo was noted in SEPP-1 [3.0 (2.1-5) vs. 3.9 (2.4-8.3) μgmL, p = 0.02] but not in GPX-3 levels [7.5 (3.4-60.6) vs. 6.3 (3.2-40.7) μgmL; p = 0.3]. Conclusion from the study: GFD-compliant CD have absolute and functional Se deficiency. Short term therapy improves the Se status and growth parameters.

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