Coeliac Disease Detected in Adulthood: Nutritional Consequences of a Decade of Delay
DOI:
https://doi.org/10.5281/zenodo.22278504Keywords:
Coeliac disease, Diagnostic delay, Micronutrient deficiency, Bone mineral density, Gluten-free dietAbstract
Coeliac disease presenting in adulthood is frequently diagnosed years after symptoms begin, and the nutritional damage accrues
in the interval. In a cohort of 500 biopsy-confirmed adults, median latency was 1.2 years in those diagnosed within two years and
5.5 years in those diagnosed later. Delay beyond two years was associated with osteoporosis or low bone density in 40 against 20
per cent, infertility in 20 against 10, and lymphoma in 5 against 1, with adjusted odds ratios of 2.50, 2.25 and 5.20 respectively.
The investigators attribute this largely to pre-existing damage present at diagnosis rather than to events occurring after treatment
began. Micronutrient deficiency is common at presentation, zinc being the most frequent at 59.4 per cent, alongside iron, vitamin
D, copper, vitamin B12 and folate. Recovery on a gluten-free diet is uneven, with zinc improving within weeks and iron deficiency
anaemia over six to twelve months.
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