Serum homocysteine levels in children with coeliac disease

Background: Vitamin B status evaluation of patients with coeliac disease reveals that these patients are more prone to develop deficiencies of vitamin B₁, B₂, B₆, folate and vitamin B₁₂ as compared to healthy controls, all of which play an important role in homocysteine metabolism.

Objectives: To study the serum homocysteine levels in children with coeliac disease and to analyse in comparison to a few related markers.

Method: A cross-sectional study was done among 36 newly diagnosed children (44.4 % females) with coeliac disease (mean age: 7.72 ± 3.26 years); and 36 age-and-sex-matched controls. Serum concentrations of homocysteine, C-reactive protein (CRP), vitamin B₁₂, and folic acid were determined after overnight fasting. Comparisons between the two groups were performed by Student’s t-test or Mann–Whitney U-test, for continuous variables. Pearson’s Chi-square test or Fisher’s exact test was used for categorical variables. Alpha level of 5% was considered significant.

Results: Biochemical assessment of the two groups revealed significantly increased serum levels of homocysteine (mean 14.1 ± 1.35 µmol/L) and CRP levels (mean 7.3 ± 2.21 mg/dL) and decreased vitamin B₁₂ levels (mean 127.11± 16.16 pg/dL) and folic acid levels (mean 5.96 ± 4.17 ng/dl ) as compared to controls. There was a negative correlation of statistical significance between vitamin B₁₂ levels, folic acid levels and homocysteine levels. Furthermore, there was a statistically significant positive correlation between CRP and homocysteine levels.

Conclusions: There were significantly decreased levels of vitamin B₁₂ and folic acid in children with coeliac disease as compared to controls. There were also significantly increased levels of CRP and serum homocysteine levels along with correlation between vitamin B₁₂ levels, folic acid levels, CRP levels and homocysteine levels.

Sri Lanka Journal of Child Health, 2021; 50(4): 589-594