Solakivi Tiina, Kaukinen Katri, Kunnas Tarja, Lehtimäki Terho, Mäki Markku, Nikkari Seppo Tapio
Department of Medical Biochemistry, University of Tampere, Finland.
Scand J Gastroenterol. 2009;44(7):826-30. doi: 10.1080/00365520902912589.
Celiac disease (CD) is characterized by villous atrophy with crypt hyperplasia and inflammation of the small intestinal mucosa leading to disturbed epithelial transport. In untreated CD, fat malabsorption can occur. The aim of this study was to investigate the profile of serum fatty acids in newly detected CD before and after treatment with a gluten-free diet.
Serum samples were obtained from 50 adults with active CD showing small-bowel mucosal villous atrophy, from the same patients in remission after treatment with a gluten-free diet, and from 59 controls. Serum fatty acids were analyzed by capillary gas-liquid chromatography.
Especially the proportions of arachidonic acid (20:4 n-6) and the long-chain polyunsaturated fatty acids of the n-3 family docosapentaenoic acid (22:5 n-3) and docosahexaenoic acid (22:6 n-3) were decreased in subjects with active CD. Serum levels of these fatty acids increased during remission, but still remained significantly lower than control values. Levels of unsaturated and monounsaturated fatty acids were generally increased in subjects with CD compared with those in controls.
In patients with CD, determination of serum fatty acid composition can be considered if the dietary history or symptoms suggest an inadequate supply of long-chain fatty acids.
乳糜泻(CD)的特征是小肠黏膜绒毛萎缩、隐窝增生和炎症,导致上皮转运紊乱。未经治疗的CD可出现脂肪吸收不良。本研究的目的是调查新诊断的CD患者在无麸质饮食治疗前后血清脂肪酸的概况。
从50例患有活动性CD且表现为小肠黏膜绒毛萎缩的成年人、59例对照者以及这些患者在接受无麸质饮食治疗缓解后采集血清样本。采用毛细管气液色谱法分析血清脂肪酸。
特别是活动性CD患者中花生四烯酸(20:4 n-6)以及n-3族长链多不饱和脂肪酸二十二碳五烯酸(22:5 n-3)和二十二碳六烯酸(22:6 n-3)的比例降低。这些脂肪酸的血清水平在缓解期升高,但仍显著低于对照值。与对照组相比,CD患者中不饱和脂肪酸和单不饱和脂肪酸水平普遍升高。
对于CD患者,如果饮食史或症状提示长链脂肪酸供应不足,可考虑测定血清脂肪酸组成。