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Measuring children’s height and weight as they grow can be a powerful indicator of whether they have the digestive condition called celiac disease, and may help doctors diagnose children with the disorder earlier, a new study finds.
When used together, five calculations that are done based a child’s height and weight — such as how much a child’s height varies from the average for age and gender, and how this measure changes over time — were able to detect celiac disease in 84 percent of boys and 88 percent of girls with the disorder, according to the study, published online today (March 2) in the journal JAMA Pediatrics.
The findings echo other studies that have also found that children with celiac disease often weigh less and don’t grow as fast or as tall as their typical peers, the researchers said. [The Top 10 Worst Hereditary Conditions]
Furthermore, when the researchers looked back at the height of children already diagnosed with celiac disease, they found girls were shorter than expected for two years before they were diagnosed, and boys were shorter for one year before their diagnosis, when compared with a reference group.
"[A] well-established growth-monitoring program could facilitate the early diagnosis of celiac disease," the researchers concluded in their study.
Celiac disease is an autoimmune disorder that causes the immune system to overreact to two proteins in gluten, which is found in wheat and other grains. If a person with celiac disease eats gluten, it can trigger an immune response that damages their intestines and prevents them from absorbing nutrients.
The disorder affects about 2 percent people in Western populations, but the majority of people who have the condition may not know it, the researchers said. Blood tests can identify an elevated immune response to gluten, but universal screening for celiac disease is not recommended, largely because the test is invasive and few people actually have the condition, the researchers said.
But the new growth parameters may increase early childhood diagnoses, the researchers found. In the study, they looked at growth data of 177 children with celiac disease and 51,332 typical children. All of the data came from medical checkups from three primary care centers in Finland from 1994 to 2009.
None of the children in the study with celiac disease had another disorder that might impact their growth, such as asthma or diabetes, the researchers noted.
The researchers used five growth-screening parameters that looked at changes in height and (BMI) mass index over time, as well as how much these measures deviated from the norm over time. Although none of the parameters were good predictors of celiac disease on their own, the quintet had good accuracy in predicting the disease, the researchers found.
In the children with celiac disease, 57 percent of the girls and 48 percent of the boys had abnormal growth two years before their diagnosis, they found. But the children weren’t diagnosed until about age 6 for girls and about age 7 for boys, the researchers said.
Of course, children can have lower-than-expected measurements for height and BMI for a number of health issues, such as inflammatory bowel disease. But up to 59 percent of children who are short for non-hormonal reasons are thought to have celiac disease, the researchers said.
Measurements of a child’s height and weight are low-cost and noninvasive, making them a simple way to screen children as they grow for celiac disease “with good accuracy,” they added.
"Consequently, we recommend systematic growth screening as a primary method for the early detection of chronic disorders that affect growth, such as celiac disease," the researchers said.
"I think the paper highlights the fact that there are ways to diagnose [celiac disease] early," said Dr. Peter Green, the director of the Celiac Disease Center at Columbia University in New York City, who was not involved with the study. "We’re looking for a way to increase diagnosis from a very low baseline."
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