Citrulline level as a marker of adherence to diet free of gluten and clinical status in children with celiac disease

Aim of the study: The assessment of serum citrulline level as a marker of clinical status of celiac disease (CD) children and its relation with their degree of adherence to gluten free diet (GFD). Patients and Methods: This is a cross-sectional study that was conducted on 60 randomly selected children (mean age 6 ± 3.21 years), diagnosed with CD within 6 months before study initiation, the patients attended the gastroenterology outpatient clinic at children hospital at Cairo University in the period from December 2019 to March 2020. After their recruitment, subjects were grouped according to their adherence to GFD into 4 groups: excellent, good, poor and no adherence. Serum citrulline levels was measured using enzyme linked immunosorbent assay and its levels compared between groups. Results: Statistically significant differences were found in serum citrulline levels between different groups with variable degrees of adherence to GFD (p=0.000). Its levels showed positive correlations with WHO weight and height z-score, hemoglobin, serum Sodium and albumin levels. Conclusion: Serum citrulline is a good indicator for the degree of adherence of CD children to GFD. Keywords: celiac disease; citrulline; gluten free diet.