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Serum Nitric Oxide Levels in Children with Celiac Disease

Ertekin, Vildan MD*; Selimoğlu, Mukadder Ayşe MD*; Türkan, Yasemin MD; Akçay, Fatih MD

Journal of Clinical Gastroenterology: October 2005 - Volume 39 - Issue 9 - p 782-785
doi: 10.1097/01.mcg.0000177240.67215.da
Alimentary Tract: Clinical Research

Objectives: To determine serum nitric oxide levels in pediatric patients with celiac disease and to compare them with the results obtained after 1 year of gluten-free diet.

Methods: We studied serum nitric oxide levels in 41 newly diagnosed patients with celiac disease. Serum levels of nitric oxide were reevaluated after 1 year of gluten-free diet in 23 of them. Mean age was 10.4 ± 3.4 years (range 2-17 years).

Results: The levels of nitric oxide in pretreatment 41 patients with celiac disease and healthy children were detected as 198.33 ± 20.22 μmol/L and 135.63 ± 21.17 μmol/L, respectively (P = 0.0001). Serum nitric oxide level, measured in the blood samples 1 year after gluten-free diet, was 148.27 ± 27.25 μmol/L (P = 0.001). Serum nitric oxide levels were statistically correlated with the degree of histologic changes in celiac disease. In the patients with celiac disease, pretreatment level of nitric oxide was not correlated with the levels of triglyceride, cholesterol, albumin, aspartate aminotransferase, alanine aminotransferase, or creatine kinase. We found correlations with the level of nitric oxide and Hb, mean corpuscular volume, and ferritin.

Conclusion: Higher serum nitric oxide levels found in children who had not compliance with gluten-free diet suggested the role of serum nitric oxide as an indicator of diet compliance. Because determination of serum nitric oxide is a simple, rapid, cheap, noninvasive, and highly sensitive method for celiac disease, we think that this parameter can be used in the evaluation of diet compliance in children with celiac disease or even instead of gluten challenge, due to more noninvasive property.

From the Departments of *Pediatric Gastroenterology and Nutrition and †Biochemistry, Atatürk University, Faculty of Medicine, Erzurum, Turkey.

Received for publication December 8, 2004; accepted February 16, 2005.

Reprints: Vildan Ertekin, MD, Atatürk Üniversitesi, Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları AD, 25200, Erzurum, Turkey (e-mail:

© 2005 Lippincott Williams & Wilkins, Inc.