Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy.
J Pediatr Gastroenterol Nutr. 2013 Feb;56(2):206-10. doi: 10.1097/MPG.0b013e31827114a4.
Leonardo da Vinci's face symmetry derives from 3 equal craniofacial segments: trichion-nasion (tn), which represents the superior third of the face, nasion-subnasal (ns) that is the medium third of the face, and subnasal-gnathion (sg) that is the length of the lower third of the face. It has been reported that adult subjects with celiac disease (CD) can be identified on the basis of a greater extension of the forehead in comparison to the medium third of the face, with a high tn/ns ratio. The aim of the present study was to investigate the correlation between facial asymmetry and CD in childhood and adulthood.
We studied 126 biopsy-proven patients with CD (76 children and 50 adults) and 102 healthy controls (43 children and 59 adults). Their faces were photographed; the pictures were edited using a software program to calculate the facial segments.
The tn length was significantly different between adult celiac and adult controls (7.43 ± 1.46 cm vs 6.38 ± 1.73 cm, P = 0.001). The cutoff of 6.5 cm tn, derived from receiver operating characteristic curve analysis, identified 43 of 50 patients (sensitivity 86%), but 34 of 59 controls were positive (specificity 54.2%). The positive predictive value was 56%; however, the tn/ns ratio was not significantly different between celiacs and controls. Neither the tn length nor the tn/ns ratio in celiacs correlated to the time of gluten exposure.
Adults, but not children, with celiac disease show a forehead extension significantly greater than controls, but this test's specificity appears too low to be used in the screening of CD.
列奥纳多·达·芬奇的面部对称性源自 3 个相等的颅面节段：顶点-鼻根点（tn），代表面部的上三分之一；鼻根点-鼻下点（ns），代表面部的中三分之一；鼻下点-颏前点（sg），代表面部的下三分之一。据报道，成人腹腔疾病（CD）患者的前额比中三分之一的面部有更大的延伸，可以根据 tn/ns 比值较高来识别。本研究旨在探讨儿童和成人期面部不对称与 CD 之间的相关性。
我们研究了 126 例经活检证实的 CD 患者（76 例儿童和 50 例成人）和 102 例健康对照者（43 例儿童和 59 例成人）。他们的面部被拍照；使用软件程序编辑照片以计算面部节段。
成人腹腔疾病患者的 tn 长度与成人对照组有显著差异（7.43 ± 1.46 cm 比 6.38 ± 1.73 cm，P = 0.001）。来自受试者工作特征曲线分析的 6.5 cm tn 截断值可识别 50 例患者中的 43 例（敏感性 86%），但 59 例对照组中有 34 例呈阳性（特异性 54.2%）。阳性预测值为 56%；然而，tn/ns 比值在腹腔疾病患者与对照组之间无显著差异。腹腔疾病患者的 tn 长度或 tn/ns 比值与谷胶暴露时间均无相关性。
成人腹腔疾病患者，但儿童腹腔疾病患者没有，其前额延伸明显大于对照组，但该测试的特异性似乎太低，无法用于 CD 的筛查。
