PT - JOURNAL ARTICLE AU - Renata Auricchio AU - Pio Stellato AU - Dario Bruzzese AU - Donatella Cielo AU - Alfredo Chiurazzi AU - Martina Galatola AU - Gemma Castilljeo AU - Paula Crespo Escobar AU - Judith Gyimesi AU - Corina Hartman AU - Sanja Kolacek AU - Sybille Koletzko AU - Ilma Korponay-Szabo AU - Maria Luisa Mearin AU - Caroline Meijer AU - Malgoscia Pieścik-Lech AU - Isabel Polanco AU - Carmen Ribes-Koninckx AU - Raanan Shamir AU - Hania Szajewska AU - Riccardo Troncone AU - Luigi Greco TI - Growth rate of coeliac children is compromised before the onset of the disease AID - 10.1136/archdischild-2019-317976 DP - 2020 Oct 01 TA - Archives of Disease in Childhood PG - 964--968 VI - 105 IP - 10 4099 - http://adc.bmj.com/content/105/10/964.short 4100 - http://adc.bmj.com/content/105/10/964.full SO - Arch Dis Child2020 Oct 01; 105 AB - Introduction Growth impairment has often been described in children who develop coeliac disease (CD). Based on data from the multicentre, longitudinal PreventCD study, we analysed the growth patterns of infants at genetic risk of CD, comparing those who developed CD by 6 years of age (CD ‘cases’, 113 infants) versus those who did not develop CD by 6 years (no CD ‘controls’, 831 infants).Methods Weight and length/height were measured using a longitudinal protocol. Raw measurements were standardised, computing z-scores for length/height and weight; a linear mixed model was fitted to the data in order to compare the rate of growth in the two cohorts.Results Neither cases nor controls had significant growth failure. However, when the mean z-scores for weight and height were analysed, there was a difference between the two groups starting at fourth month of life. When the growth pattern in the first year was analysed longitudinally using mixed models, it emerged that children who develop CD had a significantly lower growth rate in weight z-score (−0.028/month; 95% CI −0.038 to −0.017; p<0.001) and in length/height z-score (−0.018/month; 95% CI −0.031 to −0.005; p=0.008) than those who do not develop CD. When the whole follow-up period was analysed (0–6 years), differences between groups in both weight and length/height z-scores were confirmed.Conclusion The growth of children at risk of CD rarely fell below ‘clinical standards’. However, growth rate was significantly lower in cases than in controls. Our data suggest that peculiar pathways of growth are present in children who develop CD, long before any clinical or serological signs of the disease appear.