Original scientific paper

https://doi.org/https://doi.org/10.31895/hcptbn.21.si12.2

A Retrospective Study on the Effect of a Gluten-Free Diet on Vitamin D3, Iron, and Ferritin Status in Children Diagnosed with Celiac Disease

Tara Gabriela Martinko ; Faculty of food technology and biotechnology, University of Zagreb, Pierottijeva 6, Zagreb, Croatia
Valentina Puškadija ; Faculty of food technology and biotechnology, University of Zagreb, Pierottijeva 6, Zagreb, Croatia *
Sara Sila ; Children’s Hospital Zagreb, Klaićeva 16, 10000 Zagreb, Croatia
Tena Niseteo ; Faculty of food technology and biotechnology, University of Zagreb, Pierottijeva 6, Zagreb, Croatia; Children’s Hospital Zagreb, Klaićeva 16, 10000 Zagreb, Croatia

* Corresponding author.

Abstract

Vitamin D3 levels in paediatric patients with celiac disease (CeD) are known to be low at diagnosis. Introducing a gluten-free diet improves nutritional status and, accordingly, vitamin D3 levels. In patients with celiac disease, absorption of nutrients, including iron, is reduced. Short stature is also associated with CeD, 1 in 9 paediatric patients are stunted. We conducted a retrospective study using data from the Children's Hospital Zagreb. Data from 124 children diagnosed with CeD in the period from 2020 to 2024 were analysed. The median age of patients on last follow up was 9 years (range 2.7-18.3), and the median age when diagnosed was 7.6 years. Data on the children's body mass and height were collected to examine the association between nutritional status and nutritional deficiencies. The average z-score for weight-for-age is 0.15, heightfor-age is 0.47, and BMI (body mass index) -0.18. Serum vitamin D3, ferritin and iron at the time of diagnosis and after implementing a GFD were analysed. The data was processed to see the relationship between the level of vitamin D3, ferritin and serum iron after implementing a GFD. The median level of vitamin D3 when diagnosed was 60.3 nmol/L (reference >75 nmol/L). Vitamin D3 levels after on average 13 months of adherence to a GFD were 67.15 nmol/L. In the case of reduced levels of vitamin D3, supplementation ranging from 400 to 2000 IU was prescribed depending on the needs. The median level of ferritin level on the diagnosis point was 10 μg/L, and for iron it was 11.9 μmol/L (reference 10.3 - 55.8 μg/L; 8 – 30 μmol/L, respectively). After the introduction of a GFD, both values increased, ferritin to 14 μg/L, and iron to 19.2 μmol/L. The levels of vitamin D3 and ferritin were lower on the point of diagnosis of CeD. Vitamin D3 is usually supplemented and expected to be increased, however iron is not supplemented in children with CeD as it is expected that it would be corrected with GFD. Children with CeD need nutritional support and regular dietetic follow up in regard to their adherence to GFD, growth and micronutrient follow up.

Keywords

Celiac disease; pediatric population; vitamin D3; iron, ferritin; supplementation

Hrčak ID:

350855

URI

https://hrcak.srce.hr/350855

Publication date:

1.6.2026.

Article data in other languages: croatian

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