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The role of functional platelet indices in dietary monitoring of children with celiac disease
Nevzat Aykut Bayrak1, Burcu Volkan21Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Health Sciences, Zeynep Kâmil Women & Children’s Training & Research Hospital, Istanbul, Turkey.2Division of Pediatric Gastroenterology, Hepatology and Nutrition, Marmara University School of Medicine, Istanbul, Turkey
INTRODUCTION: Determining the value of platelet count, mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW) on histologic disease stage and compliance to gluten-free diet (GFD) in children with celiac disease (CD).
METHODS: Children diagnosed as CD and healthy subjects were recruited. CD patients were classified into two groups: Newly diagnosed and on GFD for over 1 year. CD patients on GFD were further divided into two groups according to their dietary adherence determined by anti tissue transglutaminase IgA levels. Samples for complete blood count were obtained from all participants.
RESULTS: A total of 236 CD patients (60 newly diagnosed, 83 with good GFD adherence, and 93 with poor GFD adherence, mean age: 11±3.9 years, 59.3% female) and 92 healthy subjects (mean age: 10.7±3.8 years, 52.2% female) were studied. Platelets, MPV, PCT, and PDW values of newly diagnosed CD and poor GFD adherence cases were statistically similar (p>0.05) while they were statistically higher than the controls and good GFD adherents (p<0.01). In ROC analysis, MPV had the highest area under the curve (0.758). The sensitivity and the specificity of MPV were 70.3% and 71.7%, respectively, for the cutoff value of 8.65 fL. Only PCT was found correlated with modified Marsh stage in newly diagnosed CD patients (r2: 0.302, p<0.05).
DISCUSSION AND CONCLUSION: This is the first report about platelet functions in children with CD. Functional platelet indices, especially MPV and PCT, would be a promising tool for indirect determination of GFD adherence and villous atrophy stage, respectively, at a low cost compared to other modalities.
Manuscript Language: English
