Background: Untreated celiac disease is traditionally believed to be associated with malabsorption and\nunderweight. However, studies describing body mass index (BMI) in individuals at the time of diagnosis have\nshown contradictory results. We investigated the differences in weight, height, and BMI in 12- year-old children\nwith screening-detected celiac disease compared to their healthy peers.\nMethods: In a population-based screening study of 12,632 12-year-old children, blood samples were analyzed\nfor markers of celiac disease. Children with elevated markers were referred for a small bowel biopsy. Weight and\nheight were measured in 239 out of 242 children with screening-detected celiac disease (57.3% girls) and in 12,227\nchildren without celiac disease (48.5% girls). BMI was categorized according to the International Obesity Task Force.\nAge- and sex-specific cut-off points for underweight, normal weight, and overweight were used.\nResults: Children with celiac disease weighed less and were shorter than their peers (median weight 45.2 kg,\ninterquartile range (IQR) 40.2ââ?¬â??52.2 kg vs. 47.0 kg, IQR 41.1ââ?¬â??54.4 kg, respectively, p = 0.01; median height 156.5 cm,\nIQR 151.0ââ?¬â??162.0 cm vs. 157.5 cm, IQR 152.0ââ?¬â??163.0 cm, respectively, p = 0.04). In comparing those with celiac\ndisease to their healthy peers, 4.2% vs. 5.2% were underweight, 82.0% vs. 72.8% were normal weight, and 13.8%\nvs. 21.9% were overweight, respectively. There was no association between being underweight and the risk of\nhaving undiagnosed celiac disease (Odds ratio (OR) 1.3, 95% CI 0.7ââ?¬â??2.4), but the risk was significantly lower\namong overweight children (OR 0.56, 95% CI 0.4ââ?¬â??0.8). Median BMI was slightly lower among the children with\nscreening-detected celiac disease compared to their healthy peers (18.6 kg/m2, IQR 17.1ââ?¬â??19.8 kg/m2 vs. 18.8 kg/m2,\nIQR 17.2ââ?¬â??21.1 kg/m2, respectively, p = 0.05), but most of the celiac disease cases had a normal BMI.\nConclusions: At a population level, children with celiac disease weigh less, are shorter, and have a lower BMI\ncompared to their peers without celiac disease, and this emphasizes the importance of early recognition and\ntreatment of the condition. However, at an individual level, growth parameters are not reliable in establishing\nthe diagnosis.
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