DIFFERENCES IN METABOLIC VARIABLES BETWEEN ADULT CELIAC PATIENTS AT DIAGNOSIS AND PATIENTS ON A GLUTEN-FREE DIET

Background: Coeliac patients often have nutrient malabsorption with nu tritional status impairment, but no report on their energy requirement s is available. In this study body composition, dietary habits, basal energy expenditure, and substrate oxidation were investigated in patie nts with the classic form of coeliac disease. Methods: Sixteen untreat ed and 18 adult coeliac patients on a gluten-free diet participated in the study. Body composition was assessed by anthropometry and bioimpe dance. Energy expenditure was measured by indirect calorimetry. A food diary over 7 days was collected. Results: Coeliac patients showed red uced body weight components but not a different fat-free mass percenta ge compared with age- and sex-matched healthy volunteers. Basal metabo lic rate normalized by fat-free mass (BMR/FFM) was higher in coeliac p atients than in controls. Untreated patients showed a significantly hi gher non-protein respiratory quotient with regard to both treated pati ents (P < 0.01) and controls (P < 0.05), an increased percentage of ca rbohydrate intake, and a good correlation between lipid faecal loss an d carbohydrate oxidation (Spearman R = 0.74; P < 0.01). Conclusions: B oth groups of patients had lower fat mass and FFM content than control s. The preferential carbohydrate oxidation in untreated patients might be a result of both lipid malabsorption and high carbohydrate intake.