A new study from researchers at Penn State College of Medicine reveals significant differences in micronutrient deficiencies and healthcare utilization among minority patients with celiac disease (CeD) compared to their non-Hispanic white counterparts. Previous research has identified racial disparities in CeD, though they have largely been related to underdiagnosis in minority groups. However, more research is needed to understand how CeD affects racial groups differently. In this retrospective cohort study, researchers assessed healthcare utilization and nutrient deficiencies.

To perform their analysis, researchers evaluated a cohort of adult patients diagnosed with celiac disease from 2016-2021 using TriNetX US Collaborative Network, which contains over 95 million patient healthcare records. The cohort was divided into two groups: 1) minority patients and 2) non-Hispanic whites.

Key Findings:

  • Nutrient deficiencies: Both groups had similar incidences of iron, vitamin B, and zinc deficiency. However, compared to non-Hispanic white patients, minority patients had significantly higher rates of vitamin D deficiency and anemia secondary to iron deficiency.
  • Healthcare Utilization: Compared to non-Hispanic whites, minority patients with CeD had a higher risk of inpatient hospital stays and emergency department visits. Further studies are needed to understand the underlying cause.

Understanding nutrient deficiencies in CeD:
Nutrient deficiencies are common in newly diagnosed CeD patients due to mucosal damage and inflammation of the small intestine, where most nutrients are absorbed. Primary nutrients of concern in CeD include vitamin D, calcium, iron, vitamin B12, folate, and zinc, all of which are essential for bone health, growth, and preventing anemia. While many nutrient deficiencies resolve after introduction of a gluten-free diet, the presence of symptoms like diarrhea and vomiting can further reduce overall intake and diet quality, increasing the risk of deficiencies.

While the factors underscoring the differences between the minority and non-Hispanic white cohorts should be examined in future research, all patients with CeD are at higher risk of developing nutrient deficiencies compared to the general population. Working with a registered dietitian is critical for preventing nutrient deficiencies in CeD.

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