Abstract
Iron deficiency anemia (IDA) occurs in 15–46% of patients with celiac disease (CD), and in some cases, it may be its only manifestation. Studies in animal models have shown that prebiotics, including inulin, may help to increase intestinal absorption of iron. The aim of this study was to evaluate the effect of a prebiotic, oligofructose-enriched inulin (Synergy 1), on iron homeostasis in non-anemic children and adolescents with celiac disease (CD) in association with a gluten-free diet (GFD). Thirty-four CD patients (4–18 years old) were randomized into two groups receiving Synergy 1 (10 g/day) or a placebo (maltodextrin) for three months. Before and after intervention, blood samples were collected from all patients for assessment of blood morphology, biochemical parameters and serum hepcidin concentration. We found that serum hepcidin concentration after the intervention was significantly decreased by 60.9% (p = 0.046) in the Synergy 1 group, whereas no significant difference was observed in the placebo group. No differences in morphological and biochemical blood parameters (including ferritin, hemoglobin and C-reactive protein (CRP)) were observed after intervention in either group. Given that hepcidin decrease may improve intestinal iron absorption, these results warrant further investigation in a larger cohort and especially in patients with IDA.
Highlights
Celiac disease (CD) is a small intestine enteropathy that is triggered by the ingestion of storage proteins from wheat, barley or rye
Anemia may accompany the intestinal presentation of celiac disease (CD), but it can be the only manifestation of the disease
CD patients this is the first prospective, randomized, treated a gluten-free diet (GFD).ofOur key finding was a significant decrease in iron plasma hepcidin in concentration study ofwith the effects oligofructose-enriched inulin
Summary
Celiac disease (CD) is a small intestine enteropathy that is triggered by the ingestion of storage proteins (gluten) from wheat, barley or rye. It occurs in genetically predisposed individuals at any age, at a frequency of 1:100 [1,2,3,4]. Characteristic features of CD include a massive lymphocytic infiltration of the lamina propria and atrophy of intestinal villi. There is a significant reduction of the intestinal absorption surface, leading to malabsorption of macro- and micronutrients [2,4,5]. Anemia may accompany the intestinal presentation of CD, but it can be the only manifestation of the disease.
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