Intestinal Permeability, Nutritional Status and Quality of Life in Celiac Disease
Condition: Celiac Disease; Nutritional Deficiency; Quality of Life
MeSH terms: Celiac Disease; Malnutrition
Study type: Observational

Summary: 
      Celiac disease is defined as an autoimmune enteropathy with malabsorption of gluten protein.
      In recent studies, it has been stated that in individuals diagnosed with celiac disease,
      intestinal epithelial barrier integrity is impaired. Increased zonulin concentration in blood
      is considered as an indicator of increased intestinal permeability.

      Gluten-free diet is the only treatment of celiac disease. Adherence to gluten free diet
      provides decreasing of intestinal permeability however gluten free diet has different aspects
      on nutritional status and health related quality of life in people with celiac disease.

      The aim of this study is to determine nutritional status, intestinal permeability and quality
      of life in people with celiac disease. In the study,it primarily hypothesized that celiac
      patients noncompliant to gluten-free diet may have increased circulating levels of zonulin
      and increased intestinal permeability compared to celiac patients compliant to gluten-free
      diet.
    

Detailed description: 
      Celiac disease is defined as an autoimmune enteropathy that progresses with malabsorption of
      gluten protein found in wheat, barley, rye and small intestinal mucosal inflammation in
      individuals with genetic predisposition. Disruption of intestinal barrier integrity play role
      in the pathogenesis of celiac disease. Zonulin levels increase in the disruption of
      intestinal permeability in celiac patients.

      At the present, the only treatment of celiac disease is life-long gluten-free diet and it
      requires strict gluten elimination . With compliance to gluten-free diet, thickening of
      intestinal mucosal layer, decreasing of villi atrophy and decreasing of transcellular
      infiltration are observed. In other studies, it was stated that adherence to gluten-free diet
      can repair intestinal permeability and decrease zonulin levels.

      While compliance to gluten-free diet is a key point to prevent progression of the disease,
      nutritional quality of the gluten-free diet affects nutritional status of patients.
      Moreover,restricted diets in terms of energy or various nutrients affect health-related
      quality of life. In studies examining all aspects of celiac disease, it has been stated that
      health-related factors reduce the quality of life in celiac patients.

      In conclusion, this study aims to investigate the presence of intestinal permeability with
      serum zonulin levels in celiac patients, to evaluate nutritional status of patients with
      anthropometric measurements and food consumption records, and to determine quality of life of
      patients with validated celiac disease questionnaire. This study in Turkey, is also first
      study that investigate all these three factors.
    

Intervention name(s): Blood draw once a time
Intervention type(s): Procedure
Intervention description(s): Investigation of intestinal permeability by measuring serum zonulin levels in blood sample
Observational model: Case-Only
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        People with celiac disease
      
Biospecimen description: 
      5 ml peripheral whole venous blood sample after 8-12 hour fasting
    
Keywords: celiac disease; gluten; zonulin; nutritional status; quality of life