乳糜泻：青少年和年轻成年人遵循无麸质饮食的预测因素。

Celiac disease: predictors of compliance with a gluten-free diet in adolescents and young adults.

机构信息

Department of Pediatrics, University of Magna Graecia, Catanzaro, Italy.

出版信息

J Pediatr Gastroenterol Nutr. 2010 Jan;50(1):54-60. doi: 10.1097/MPG.0b013e31819de82a.

DOI:10.1097/MPG.0b013e31819de82a

PMID:19644397

Abstract

AIMS

To identify risk as well as protective factors related to compliance with the gluten-free diet in a cohort of teenagers with celiac disease (CD).

PATIENTS AND METHODS

Two hundred four patients with CD (European Society for Pediatric Gastroenterology, Hepatology, and Nutrition criteria) older than or equal to 13 years and residents of Campania (southern Italy) were enrolled in the study. Patients underwent clinical examination and blood sampling, and were interviewed about school performance, social relationships, family integration, smoking habit, and compliance with a gluten-free diet. Anti-tissue transglutaminase antibodies were assayed with an enzyme-linked immunosorbent assay.

RESULTS

One hundred fifty of 204 (73.5%) reported no dietary transgressions, and 54 of 204 (26.5%) reported occasional or frequent transgressions. During the previous month 29 of 54 (53.7%) poor compliers ate from 0.001 to 1 g of gluten per day, 14 (25.9%) from 1 to 5 g, and 11 (20.4%) more than 5 g. The daily intake of gluten was significantly related to anti-tissue transglutaminase antibodies (chi2 = 38.872, P = 0.000). Height was below the third percentile in 19 of 204 (9.3%), and weight was above the 97th percentile in 20 of 204 (9.8%). Diet compliance did not seem to influence the weight and height. One hundred eleven of 150 good compliers (74%) and 31 of 54 (57.4%) poor compliers were asymptomatic. Most patients reported good family relationships (88.7%), social relationships (91.2%), and school integration (88.2%). Alternatively, 54% of patients reported some limitation in their social life. Compliance was good in patients who reported excellent school integration (83%) and social relationships (81%).

CONCLUSION

Optimal school integration significantly contributes to the likelihood of good compliance. A better understanding within the school environment about CD-related issues could improve motivation to adhere to a gluten-free diet.

摘要

目的

在一组患有乳糜泻的青少年队列中，确定与无麸质饮食依从性相关的风险和保护因素。

方法

研究纳入了 204 名年龄大于或等于 13 岁且居住在坎帕尼亚（意大利南部）的乳糜泻患者（欧洲小儿胃肠病学、肝病学和营养学会标准）。患者接受了临床检查和血液采样，并接受了有关学业成绩、社交关系、家庭融合、吸烟习惯和无麸质饮食依从性的访谈。采用酶联免疫吸附试验检测抗组织转谷氨酰胺酶抗体。

结果

204 名患者中有 150 名（73.5%）报告没有饮食违规，54 名（26.5%）报告偶尔或经常违规。在过去的一个月里，54 名不良依从者中有 29 名（53.7%）每天摄入 0.001 至 1 克的麸质，14 名（25.9%）摄入 1 至 5 克，11 名（20.4%）摄入超过 5 克。每日麸质摄入量与抗组织转谷氨酰胺酶抗体显著相关（卡方=38.872，P=0.000）。204 名患者中有 19 名（9.3%）身高低于第三百分位，204 名患者中有 20 名（9.8%）体重高于第 97 百分位。饮食依从性似乎不会影响体重和身高。150 名良好依从者中有 111 名（74%）和 54 名不良依从者中有 31 名（57.4%）无症状。大多数患者报告家庭关系良好（88.7%）、社交关系良好（91.2%）和学校融合良好（88.2%）。然而，54%的患者报告他们的社交生活受到一些限制。在报告学校融合良好（83%）和社交关系良好（81%）的患者中，依从性良好。