Celiac Disease - NIH Consensus Development Program - National ...

consequences in asymptomatic at-risk populations pertained to studies of type 1 diabeticsscreened for CD. Few studies correlated the histological grade at biopsy with a change inoutcomes.ResultsThe search identified 1,199 potentially relevant citations. After 3 levels of screening,35 published studies fulfilled all the eligibility criteria. Sixteen relevant articles were identifiedfrom other celiac objectives in addition to a search on osteoporosis/CD, for a total of 51 studies.The search strategy did not identify any studies that would allow us to address the specificbenefits and harms of testing with different strategies for CD.Body Composition/AnthropometricsIn general, body composition and anthropometric parameters such as weight, body massindex (BMI), and fat mass improved after starting a GFD in symptomatic populations of CD.Individuals with CD on a strict GFD may have a lower BMI due to lower daily energy intakes.AnemiaThe studies evaluating the impact of a GFD on anemia demonstrated an improvement ona GFD with some studies linking recovery to improvement in villous atrophy. Iron-deficiencyanemia improved 6–12 months after starting a GFD, but results indicated that iron deficiency(ferritin levels) may take longer to resolve.Diabetic controlDiabetic control as measured by HbA1c levels did not improve after the institution of aGFD, although an improvement in body composition parameters was noted.ComplianceStudies that assessed the outcome of compliance with a strict GFD in adolescentpopulations suggested that diagnosis in early childhood or symptomatic clinical presentationwere associated with significant improvements in compliance with the GFD.CostsThere were five studies that evaluated the costs of different screening strategies and onlyone contained the majority of the components that are recommended for the reporting ofcost-effectiveness analyses. (1)88