Lewis Nina R, Sanders David S, Logan Richard F A, Fleming Kate M, Hubbard Richard B, West Joe
Division of Epidemiology and Public Health, Medical School, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK.
Br J Nutr. 2009 Aug;102(4):509-13. doi: 10.1017/S0007114509297248.
Recent studies have suggested that untreated coeliac disease is associated with lower total cholesterol than in the general population while the effect of treatment with a gluten-free diet on the cholesterol profile of clinically apparent coeliac disease is not known. We measured the cholesterol profile at diagnosis, and compared this with Health Survey for England figures, and again following 12 months treatment with a gluten-free diet in 100 consecutive adults with coeliac disease attending the Royal Hallamshire Hospital, Sheffield, UK. The mean total cholesterol was 4.84 (SD 1.2) mmol/l in adults (mean age 51 (SD 16) years) newly diagnosed with coeliac disease. At diagnosis of coeliac disease, men had 21% lower and women had 9% lower mean total cholesterol in comparison to the general population (difference in age-adjusted mean total cholesterol -1.09 mmol/l (95% CI -0.97, - 1.21); -0.46 mmol/l (95% CI -0.24, -0.68), respectively). There was no change in mean total cholesterol following treatment. However, there was a small but statistically significant increase of 0.12 mmol/l (95% CI 0.05, 0.18) in the mean HDL-cholesterol. Total cholesterol was lower at diagnosis in coeliac patients than in the general population and did not increase with 1 year of a gluten-free diet while HDL-cholesterol increased following treatment. Any increase in risk of IHD or stroke in people with coeliac disease is unlikely due to an adverse cholesterol profile either before diagnosis or after treatment with a gluten-free diet.
近期研究表明，未经治疗的乳糜泻患者总胆固醇水平低于普通人群，而无麸质饮食治疗对临床显性乳糜泻患者胆固醇水平的影响尚不清楚。我们对100名连续就诊于英国谢菲尔德皇家哈勒姆郡医院的乳糜泻成年患者进行了诊断时的胆固醇水平测量，并与英格兰健康调查数据进行比较，且在接受无麸质饮食治疗12个月后再次测量。新诊断为乳糜泻的成年患者（平均年龄51（标准差16）岁）平均总胆固醇为4.84（标准差1.2）mmol/L。在乳糜泻诊断时，与普通人群相比，男性平均总胆固醇低21%，女性低9%（年龄调整后的平均总胆固醇差异分别为-1.09 mmol/L（95%置信区间-0.97，-1.21）；-0.46 mmol/L（95%置信区间-0.24，-0.68））。治疗后平均总胆固醇无变化。然而，平均高密度脂蛋白胆固醇有小幅但具有统计学意义的升高，为0.12 mmol/L（95%置信区间0.05，0.18）。乳糜泻患者诊断时的总胆固醇低于普通人群，无麸质饮食治疗1年后总胆固醇未升高，而高密度脂蛋白胆固醇在治疗后升高。乳糜泻患者发生缺血性心脏病或中风风险的任何增加不太可能是由于诊断前或无麸质饮食治疗后的不良胆固醇水平所致。
