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BETA
Myléus, Anna, MD PhD
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Publications (10 of 23) Show all publications
Johansson, K., Norström, F., Nordyke, K. & Myléus, A. (2019). Celiac Dietary Adherence Test simplifies Determining Adherence to a Gluten-Free Diet in Swedish Adolescents. Journal of Pediatric Gastroenterology and Nutrition - JPGN
Open this publication in new window or tab >>Celiac Dietary Adherence Test simplifies Determining Adherence to a Gluten-Free Diet in Swedish Adolescents
2019 (English)In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objectives: The aims of the study were to ascertain whether the Celiac Dietary Adherence Test (CDAT) could contribute in determining adherence to a gluten-free diet in celiac disease patients and to evaluate the diet adherence and well-being of a study population five years after a celiac disease screening known as “Exploring the Iceberg of Celiacs in Sweden”.

Methods: Through the screening, 90 adolescents (born 1997) were diagnosed with biopsy-proven celiac disease at twelve-years of age. Of them, 70 (78%) came to a five-year follow-up where anti–tissue transglutaminase antibodies 2 (TG2-IgA) was tested and a questionnaire was filled in, including CDAT, which consists of seven questions related to adherence. Non-parametrical tests were utilized to determine associations between adherence measures.

Results: Among the adolescents, 86% were adherent to a gluten-free diet five years after screening, 38% reported their general well-being as excellent, 50% very well, and 12% well. Statistically significant associations were seen between TG2-IgA and the CDAT score (p=0.033), and the self-reported adherence question and the CDAT score (p < 0.001).

Conclusions: The screening-detected adolescents reported a high level of well-being and adherence to a gluten-free diet five years after screening. We conclude that the CDAT can be used in clinical practice as an estimation of adherence to a gluten-free diet. It would be most suitable to use in conjunction with currently used adherence measures, but can also be used as a stand-alone method when others are not accessible.

Place, publisher, year, edition, pages
Wolters Kluwer, 2019
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-162417 (URN)10.1097/MPG.0000000000002451 (DOI)
Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2019-08-22
Myléus, A., Stenhammar, L., Högberg, L., Browaldh, L., Daniels, I.-M., Fagerberg, U. L., . . . Ivarsson, A. (2019). Questionnaire showed that Swedish paediatric clinics complied well with the revised European guidelines for diagnosing coeliac disease. Acta Paediatrica, 108(6), 1140-1143
Open this publication in new window or tab >>Questionnaire showed that Swedish paediatric clinics complied well with the revised European guidelines for diagnosing coeliac disease
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2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 6, p. 1140-1143Article in journal (Refereed) Published
Abstract [en]

Aim: In 2012, revised criteria for diagnosing childhood coeliac disease were published by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition and incorporated into the revised Swedish guidelines the same year. These made it possible, in certain cases, to diagnose coeliac disease without taking small bowel biopsies. This survey assessed the extent to which the new guidelines were implemented by Swedish paediatric clinics two years after their introduction.

Methods: In October 2014, we distributed a paper questionnaire including five questions on diagnostic routines to the 40 paediatric clinics in university or regional hospitals in Sweden that perform small bowel biopsies.

Results: All 36 (90%) clinics that responded used anti-tissue transglutaminase antibodies as the initial diagnostic test and some also used serological markers. Most clinics (81%) used endoscopy and took multiple duodenal biopsies, whereas only a few (19%) occasionally employed a suction capsule. Almost all clinics (86%) omitted taking small bowel biopsies in symptomatic children with repeatedly high coeliac serology and positive genotyping, thereby avoiding the need for invasive endoscopy under anaesthesia.

Conclusion: The 2012 Swedish Paediatric Coeliac Disease Diagnostic Guidelines had been widely accepted and implemented in routine health care two years after their introduction.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
Coeliac disease, Diagnosis, Guidelines, Small bowel biopsies, Survey
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-154663 (URN)10.1111/apa.14669 (DOI)000467867900026 ()30496613 (PubMedID)2-s2.0-85058447406 (Scopus ID)
Available from: 2018-12-21 Created: 2018-12-21 Last updated: 2019-06-19Bibliographically approved
Myléus, A., Reilly, N. R. & Green, P. H. .. (2019). Rate, Risk Factors and Outcomes of Non-adherence in Pediatric Patients with Celiac Disease: a Systematic Review. Clinical Gastroenterology and Hepatology, Article ID 31173891.
Open this publication in new window or tab >>Rate, Risk Factors and Outcomes of Non-adherence in Pediatric Patients with Celiac Disease: a Systematic Review
2019 (English)In: Clinical Gastroenterology and Hepatology, ISSN 1542-3565, E-ISSN 1542-7714, article id 31173891Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND AND AIMS: The only treatment for celiac disease is strict adherence to a gluten-free diet (GFD). We performed a systematic review to investigate the rate of adherence to a GFD in children with celiac disease, risk factors that affect adherence, and outcomes of non-adherence.

METHODS: We searched PubMed, Cochrane Library, EBSCO, and Scopus for studies through January 2019. We included observational studies of ≥50 children diagnosed with celiac disease and recommended for placement on a GFD. We collected data on adherence assessment (self-report, serology tests, structured dietary interview, biopsies, or assays for gluten immunogenic peptides), risk factors, and outcomes related to adherence. Findings were presented with medians, range, and a narrative synthesis.

RESULTS: We identified 703 studies; of these, 167 were eligible for full-text assessment and 49 were included in the final analysis, comprising 7850 children. Rates of adherence to a GFD ranged from 23% to 98%. Comparable rates (median rates of adherence, 75%-87%) were found irrespective of how assessments were performed. Adolescents were at risk of non-adherence and children whose parents had good knowledge about celiac disease adhered more strictly. Non-adherence associated with patient growth, symptoms, and quality of life.

CONCLUSION: In a systematic review of 49 studies of children with celiac disease, we found substantial variation in adherence to a GFD among patients. Rate of adherence was not associated with method of adherence measurement, so all methods appear to be useful, with lack of consensus on the ideal metric. Studies are needed to determine the best method to ensure adherence and effects on long-term health.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
compliance; follow up; food intolerance; wheat
National Category
Gastroenterology and Hepatology Pediatrics
Identifiers
urn:nbn:se:umu:diva-160024 (URN)10.1016/j.cgh.2019.05.046 (DOI)
Available from: 2019-06-11 Created: 2019-06-11 Last updated: 2019-06-13
Ragnarsson, S., Myléus, A., Hurtig, A.-K., Sjöberg, G., Rosvall, P.-Å. & Petersen, S. (2019). Recurrent Pain and Academic Achievement in School-Aged Children: A Systematic Review. Journal of School Nursing
Open this publication in new window or tab >>Recurrent Pain and Academic Achievement in School-Aged Children: A Systematic Review
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2019 (English)In: Journal of School Nursing, ISSN 1059-8405, E-ISSN 1546-8364Article, review/survey (Refereed) Epub ahead of print
Abstract [en]

Recurrent pain and school failures are common problems in children visiting the school nurses office. The overall aim of the current study was to investigate the relationship between recurrent pain and academic achievement in school-aged children. Literature was searched in seven electronic databases and in relevant bibliographies. Study selection, data extraction, and study and evidence quality assessments were performed systematically with standardized tools. Twenty-one studies met the inclusion criteria and 13 verified an association between recurrent pain (headache, stomachache, and musculoskeletal pain) and negative academic achievement. Two longitudinal studies indicated a likely causal effect of pain on academic achievement. All studies had substantial methodological drawbacks and the overall quality of the evidence for the identified associations was low. Thus, children’s lack of success in school may be partly attributed to recurrent pain problems. However, more highquality studies are needed, including on the direction of the association and its moderators and mediators.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
recurrent pain, school-aged children, school failure, school nursing
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology Learning
Identifiers
urn:nbn:se:umu:diva-157030 (URN)10.1177/1059840519828057 (DOI)
Available from: 2019-03-06 Created: 2019-03-06 Last updated: 2019-04-03
Abraha, A., Myléus, A., Byass, P., Kahsay, A. & Kinsman, J. (2019). Social determinants of under-5 child health: A qualitative study in Wolkayit Woreda, Tigray Region, Ethiopia. PLoS ONE, 14(6), Article ID e0218101.
Open this publication in new window or tab >>Social determinants of under-5 child health: A qualitative study in Wolkayit Woreda, Tigray Region, Ethiopia
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2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 6, article id e0218101Article in journal (Refereed) Published
Abstract [en]

Despite the significant reductions seen in under-5 child mortality in Ethiopia over the last two decades, more than 10,000 children still die each year in Tigray Region alone, of whom 75% die from preventable diseases. Using an equity lens, this study aimed to investigate the social determinants of child health in one particularly vulnerable district as a means of informing the health policy decision-making process. An exploratory qualitative study design was adopted, combining focus group discussions and qualitative interviews. Seven Focus Group Discussions with mothers of young children, and 21 qualitative interviews with health workers were conducted in Wolkayit district in May-June 2015. Data were subjected to thematic analysis. Mothers’ knowledge regarding the major causes of child mortality appeared to be good, and they also knew about and trusted the available child health interventions. However, utilization and practice of these interventions was limited by a range of issues, including cultural factors, financial shortages, limited female autonomy on financial resources, seasonal mobility, and inaccessible or unaffordable health services. Our findings pointed to the importance of a multi-sectoral strategy to improve child health equity and reduce under-5 mortality in Wolkayit. Recommendations include further decentralizing child health services to local-level Health Posts, and increasing the number of Health Facilities based on local topography and living conditions.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-160500 (URN)10.1371/journal.pone.0218101 (DOI)000471238300048 ()31194787 (PubMedID)
Funder
Swedish Research Council, C0615601
Available from: 2019-06-19 Created: 2019-06-19 Last updated: 2019-07-11Bibliographically approved
Norström, F., van der Pals, M., Myléus, A., Hammarroth, S., Högberg, L., Isaksson, A., . . . Carlsson, A. (2018). Impact of Thyroid Autoimmunity on Thyroid Function in 12-year-old Children With Celiac Disease. Journal of Pediatric Gastroenterology and Nutrition - JPGN, 67(1), 64-68
Open this publication in new window or tab >>Impact of Thyroid Autoimmunity on Thyroid Function in 12-year-old Children With Celiac Disease
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2018 (English)In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 67, no 1, p. 64-68Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Celiac disease (CD) is associated with thyroid autoimmunity and other autoimmune diseases. However, data are lacking regarding the relationship between thyroid autoimmunity and thyroid function, especially in regard to CD. Our aim was to investigate the impact of thyroid autoimmunity on thyroid function in 12-year-old children with CD compared to their healthy peers.

METHODS: A case-referent study was conducted as part of a CD screening of 12-year-olds. Our study included 335 children with CD and 1,695 randomly selected referents. Thyroid autoimmunity was assessed with antibodies against thyroid peroxidase (TPOAb). Thyroid function was assessed with thyroid stimulating hormone and free thyroxine.

RESULTS: TPOAb positivity significantly increased the risk of developing hypothyroidism in all children. The odds ratios (with 95% confidence intervals) were: 5.3 (2.7-11) in healthy 12-year-olds, 10 (3.2-32) in screening-detected CD cases, 19 (2.6-135) in previously diagnosed CD cases, and 12 (4.4-32) in all CD cases together. Among children with TPOAb positivity, hypothyroidism was significantly more common (odds ratio 3.1; 95% CI 1.03-9.6) in children with CD (10/19) than in children without CD (12/46).

CONCLUSIONS: The risk of thyroid dysfunction due to thyroid autoimmunity is larger for those with CD than their healthy peers. Our study indicate that a gluten-free diet does not reduce the risk of thyroid dysfunction. Further studies are required for improved understanding of the role of the gluten-free diet for the risk of autoimmune diseases in children with CD.

National Category
Public Health, Global Health, Social Medicine and Epidemiology Gastroenterology and Hepatology
Research subject
Epidemiology
Identifiers
urn:nbn:se:umu:diva-144634 (URN)10.1097/MPG.0000000000001903 (DOI)000441421500019 ()29373441 (PubMedID)
Available from: 2018-02-08 Created: 2018-02-08 Last updated: 2019-05-21Bibliographically approved
Namatovu, F., Olsson, C., Lindkvist, M., Myléus, A., Högberg, U., Ivarsson, A. & Sandström, O. (2016). Maternal and perinatal conditions and the risk of developing celiac disease during childhood.. BMC Pediatrics, 16, Article ID 77.
Open this publication in new window or tab >>Maternal and perinatal conditions and the risk of developing celiac disease during childhood.
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2016 (English)In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 16, article id 77Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Celiac disease (CD) is increasing worldwide, which might be due to the changing environmental and lifestyle exposures. We aimed to explore how conditions related to maternity, delivery and the neonatal period influence CD onset during childhood.

METHODS: Using Sweden's national registers we had access to information on 1 912 204 children born between 1991 and 2009, 6 596 of whom developed CD before 15 years of age. Logistic regression analyses were performed to determine how CD is associated with maternity, delivery and the neonatal period.

RESULTS: Regardless of sex, a reduction in CD risk was observed in children born to mothers aged ≥35 years (odds ratio [OR] 0.8; 95 % confidence interval [CI] 0.7-0.9) and with high maternal income (OR 0.9; 95 % CI 0.8-0.9). Being a second-born child, however, was positively associated with CD. Among boys, elective caesarean delivery increased the risk of CD (OR 1.2; 95 % CI 1.0-1.4), while maternal overweight (OR 0.9; 95 % CI 0.8-0.9), premature rupture of the membrane (OR 0.4; 95 % CI 0.2-0.8) and low birth weight showed a negative association. Girls had an increased CD risk compared to boys and in girls the risk was increased by repeated maternal urinary tract infections (OR 1.1; 95 % CI 1.0-1.2).

CONCLUSIONS: Elective caesarean delivery and repeated maternal urinary tract infections during pregnancy are associated with increased risk of CD onset during childhood, suggesting the role of dysbiosis during early life. High maternal age and high income reduced the risk of CD, which might be due to infant-feeding practices and life style.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-122411 (URN)10.1186/s12887-016-0613-y (DOI)000377535900001 ()27267234 (PubMedID)
Available from: 2016-06-17 Created: 2016-06-17 Last updated: 2019-06-05Bibliographically approved
Ahangari, A., Stewart Williams, J. & Myléus, A. (2016). Pain and alcohol consumption among older adults: findings from the World Health Organization Study on global AGEing and adult health, Wave 1. Tropical medicine & international health, 21(10), 1282-1292
Open this publication in new window or tab >>Pain and alcohol consumption among older adults: findings from the World Health Organization Study on global AGEing and adult health, Wave 1
2016 (English)In: Tropical medicine & international health, ISSN 1360-2276, E-ISSN 1365-3156, Vol. 21, no 10, p. 1282-1292Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To investigate cross-sectional associations between self-reported recent pain and alcohol use/abstinence, and previous-day pain and previous-week alcohol consumption in adults aged 50 + in six low- and middle-income countries (LMICs). METHODS: The WHO Study on global AGEing and adult health (SAGE) Wave 1 (2007-2010) in China, Ghana, India, Mexico, Russia and South Africa is the data source. Prevalence of alcohol use/abstinence is reported by previous-day and previous-month pain. Multinomial logistic regressions (crude and adjusted for sex and country) tested associations between recent pain and alcohol use in the pooled multicountry sample. RESULTS: Across the six SAGE countries, about one-third of respondents reported alcohol use, being highest in Russia (74%) and lowest in India (16%). Holding the effects of sex and country constant, compared with abstainers, people with previous-day pain were more likely to be previous-day or other users. With regard to the quantity and frequency of alcohol use, people with previous-day pain were more likely to be non-heavy drinkers. CONCLUSION: Overall, we found that, in this population of older adults in six LMICs, recent pain was associated with moderate use of alcohol, although there were differences between countries. The findings provide a platform for country-specific research to better understand bi-directional associations between pain and alcohol in older adults.

Abstract [fr]

OBJECTIF: Etudier les associations transversales entre la douleur récente auto-déclarée et la consommation/abstinence d'alcool, et la douleur au cours du jour précédent et la consommation d'alcool au cours de la semaine précédente chez les adultes âgés de 50 ans et plus dans six pays à revenus faibles et moyens (PRFM). MÉTHODES: L’étude de l’OMS sur le vieillissement mondiale et la santé des adultes (étude SAGE) Vague 1 (2007-2010) en Chine, au Ghana, en Inde, au Mexique, en Russie et en Afrique du Sud constituait la source des données. La prévalence de la consommation/abstinence d'alcool a été rapportée selon la douleur au cours du jour précédent et du mois précédent. Les régressions logistiques multinomiales (brutes et ajustées pour le sexe et le pays) ont testé les associations entre la douleur récente et la consommation d'alcool dans l’échantillon poolé des pays. RÉSULTATS: Dans les six pays SAGE, environ un tiers des répondants ont rapporté la consommation d'alcool, étant la plus élevée en Russie (75%) et la plus faible en Inde (16%). En maintenant constants les effets du sexe et du pays, les personnes souffrant de douleur du jour précédent étaient plus susceptibles d’être des consommateurs du jour précédent ou à d'autres moments, comparées aux abstinents. En ce qui concerne la quantité et la fréquence de la consommation d'alcool, les gens souffrant de douleur du jour précédent étaient plus susceptibles d’être des non gros buveurs. CONCLUSION: Dans l'ensemble nous avons constaté que, dans cette population de personnes âgées dans six PRFM, la douleur récente était associée à une consommation modérée d'alcool, bien qu'il y ait des différences entre les pays. Les résultats fournissent une plate-forme pour la recherche spécifique au pays pour mieux comprendre les associations bidirectionnelles entre la douleur et l'alcool chez les personnes âgées.

Abstract [es]

OBJETIVO: Investigar las asociaciones croseccionales entre dolor reciente autoreportado y uso de alcohol / abstinencia, y dolor el día anterior y consume de alcohol la semana anterior entre adultos con una edad de +50 años en seis países con ingresos bajos y medios (PIBMs). MÉTODOS: Se utilizó como fuente de datos el estudio de la OMS sobre envejecimiento y salud de los adultos en el mundo (SAGE), primera etapa (2007-2010) realizado en China, Ghana, India, Méjico, Rusia y Sudáfrica. La prevalencia del uso de alcohol / abstinencia se reportaba según el nivel de dolor del día anterior o del mes anterior. Mediante regresiones logísticas multinomiales (crudas y ajustadas según sexo y país) se evaluaron las asociaciones entre el dolor reciente y el uso de alcohol en una muestra agrupada multinacional. RESULTADOS: En seis países SAGE, aproximadamente un tercio de quienes respondieron reportaron el uso del alcohol, siendo el más alto en Rusia (75%) y el más bajo en India (16%). Manteniendo constantes los efectos del sexo y del país, y comparando con quienes se abstenían, las personas con dolor el día previo tenían una mayor probabilidad de haber tomado alcohol el día anterior u otros usuarios. Con respecto a la cantidad y la frecuencia en el uso del alcohol, las personas con dolor el día anterior tenían una mayor probabilidad de no ser bebedores empedernidos. CONCLUSIÓN: En general encontramos que, en esta población de adultos mayores en seis PIBMs, el dolor reciente estaba asociado con un uso moderado del alcohol, aunque había diferencias entre países. Los hallazgos proveen una plataforma para investigaciones específicas por países, con el fin de entender mejor las asociaciones bidireccionales entre dolor y alcohol en adultos mayores.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2016
Keywords
chronic, disability, ageing, aging, developing countries, low- and middle-income countries, chronique, invalidité, vieillissement, pays en voie de développement, pays à revenus aibles et moyens, crónico, discapacidad, envejecimiento, países en vías de desarrollo, países con ingresos medios y bajos
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-126696 (URN)10.1111/tmi.12757 (DOI)000387592800007 ()27443945 (PubMedID)
Available from: 2016-10-13 Created: 2016-10-13 Last updated: 2019-06-05Bibliographically approved
Webb, C., Norström, F., Myléus, A., Ivarsson, A., Halvarsson, B., Högberg, L., . . . Carlsson, A. (2015). Celiac disease can be predicted by high levels of anti-tissue transglutaminase antibodies in population-based screening. Journal of Pediatric Gastroenterology and Nutrition - JPGN, 60(6), 787-791
Open this publication in new window or tab >>Celiac disease can be predicted by high levels of anti-tissue transglutaminase antibodies in population-based screening
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2015 (English)In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 60, no 6, p. 787-791Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To evaluate any potential correlation between anti-tissue transglutaminase antibodies of type immunoglobulin A (tTG-IgA) and the degree of gluten induced enteropathy in children participating in a screening study for celiac disease (CD) and to assess to what extent the revised ESPGHAN (European Society for Paediatric Gastroenterology, Hepatology and Nutrition) guidelines cover this group of patients.

METHODS: This is a sub-study of a cross-sectional CD screening study, ETICS (Exploring the Iceberg of Celiacs in Sweden), a two-phased study performed during 2005-2006 and 2009-2010. The 13,279 participating children had a blood test obtained and those with positive tTG-IgA were recommended a small intestinal biopsy. The tTG-IgA levels at the time of biopsy were compared with the assessment of the biopsy.

RESULTS: There were 267 children included, of whom 230 were diagnosed with CD. Out of all children, 67 children had low tTG-IgA levels (<5 U/mL), whereof 55% had Marsh 3 lesions. All children with tTG-IgA levels exceeding 10 times the upper limit of normal values of 5 U/mL, i.e. 50 U/mL, were diagnosed with CD. Lowering the cut-off to 3 U/mL, all but one child with 30 U/mL got CD diagnosis.

CONCLUSION: By adapting the revised ESPGHAN criteria, biopsies could have been omitted in a fourth of all cases. Our results indicate, that the criteria might be useful even on screened children. Further studies are needed to confirm whether the 2012 ESPGHAN guidelines should be revised to also apply to the populations being screened.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2015
Keywords
celiac disease, diagnosis, enteropathy, screening, serological markers
National Category
Gastroenterology and Hepatology Pediatrics Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-97984 (URN)10.1097/MPG.0000000000000688 (DOI)000355242100016 ()25564816 (PubMedID)
Available from: 2015-01-12 Created: 2015-01-12 Last updated: 2018-06-07Bibliographically approved
Webb, C., Myléus, A., Norström, F., Hammarroth, S., Högberg, L., Lagerqvist, C., . . . Carlsson, A. (2015). High adherence to a gluten-free diet in adolescents with screening-detected celiac disease. Journal of Pediatric Gastroenterology and Nutrition - JPGN, 60(1), 54-59
Open this publication in new window or tab >>High adherence to a gluten-free diet in adolescents with screening-detected celiac disease
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2015 (English)In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 60, no 1, p. 54-59Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To evaluate the gluten-free diet (GFD) adherenceafter one year of follow-up in children with screening-detected celiac disease (CD) in a general population. METHODS: A total of 18,325 12 year olds were invited to participate in apopulation-based CD screening (ETICS- Exploring the Iceberg of Celiacs in Sweden), of whom 13,279 participated. In 240 children, CD was detected through elevated anti-tissue transglutaminase antibodies 2 (TG2-IgA) and verified by a small-intestinal biopsy. This sub-study included the 210 children with TG2-IgAevaluated both at the initialbiopsy occasion and at the one-year follow-up. GFD adherence was evaluated by a combination of TG2-IgA measurements and self-reported adherence (n = 193). RESULTS: After one year, 83% (179/210) had normalizedTG2-IgA levels (<5U/mL). Among those who had >50 U/mL at diagnosis,25% (16/63) still had elevated TG2-IgA but for the majority their initial values were more than halved. Most reported a high level ofGFD adherence ('always' 75%(158/193) and 'often' 14%(30/193)), and 75% (145/193) reported always adhereingcombined with normalized TG2-IgA. Although reporting that they were always adherent, 13 (6.7%) had not yet normalized their TG2-IgA levels completely, however, a majority of these initially had the highestTG2-IgA levels. CONCLUSIONS: GFD adherence is high in adolescents with CD detected by screening of the general population of Swedish 12yearolds. Almost all had normalized serology and reported GFD adherenceat the one-year follow-up. However, a few adolescents whoreported GFD adherence still had elevated TG2-IgA levelssuggesting more severe disease and/or non-adherence.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2015
Keywords
adolescents, anti-tissue transglutaminase antibodies, celiac disease, gluten-free diet, screening
National Category
Pediatrics Public Health, Global Health, Social Medicine and Epidemiology Gastroenterology and Hepatology Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-93535 (URN)10.1097/MPG.0000000000000571 (DOI)000348460100017 ()25238121 (PubMedID)
Available from: 2014-09-24 Created: 2014-09-24 Last updated: 2018-06-07Bibliographically approved
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