Department of Medicine, Celiac Disease Center, Columbia University, 180 Fort Washington Avenue, Suite 936, New York, NY, 10032, USA.
Dig Dis Sci. 2014 Jun;59(6):1255-61. doi: 10.1007/s10620-013-2981-6. Epub 2013 Dec 28.
Gastrointestinal symptoms that respond to the removal of wheat and/or gluten are becoming more common. Patients who avoid wheat and/or gluten (PWAWG) are a heterogeneous group and predominantly self-diagnosed prior to presenting for clinical evaluation.
We characterized PWAWGs seen at a tertiary care referral center and compared them to patients with celiac disease (CD) and subjects in the National Health and Nutrition examination survey (NHANES).
This was a cross-sectional study evaluating patients seen by four gastroenterologists at a CD referral center. Baseline characteristics, laboratory values, and medical comorbidities were compared to CD patients who presented at the same center and subjects enrolled in NHANES.
Eighty-four PWAWGs were identified and compared to 585 CD patients and 2,686 NHANES patients. Thirty-two alternative diagnoses were made in 25 (30%) PWAWGs, including small intestinal bacterial overgrowth and fructose/lactose intolerance. When compared to patients with CD, PWAWGs had similar body mass index (BMI, 23.1 vs. 23.5, p = 0.54) and mean hemoglobin value (13.4 vs. 13.3, p = 0.6). When compared to male and female patients in NHANES, BMI, folate, and mean hemoglobin values were lower in PWAWGs. Both male and female PWAWGs had a lower prevalence of hypertension.
While there are similarities between CD and PWAWGs that could possibly be due to shared HLA haplotypes or an effect of the gluten-free diet, alternative diagnoses are common in these patients. PWAWGs have a similar cardiovascular profile as CD patients in terms of lower BMI and lower prevalence of hypertension.
对小麦和/或麸质去除有反应的胃肠道症状变得越来越常见。避免小麦和/或麸质的患者（PWAWG）是一个异质群体，主要是在临床评估前自我诊断。
我们对在三级保健转诊中心就诊的 PWAWG 患者进行了特征描述，并将其与乳糜泻（CD）患者和国家健康和营养检查调查（NHANES）中的受试者进行了比较。
这是一项横断面研究，评估了四位 CD 转诊中心的胃肠病学家就诊的患者。将基线特征、实验室值和合并症与在同一中心就诊的 CD 患者和 NHANES 中的受试者进行比较。
确定了 84 名 PWAWG 患者，并与 585 名 CD 患者和 2686 名 NHANES 患者进行了比较。在 25 名（30%）PWAWG 患者中做出了 32 种替代诊断，包括小肠细菌过度生长和果糖/乳糖不耐受。与 CD 患者相比，PWAWG 患者的体重指数（BMI）相似（23.1 对 23.5，p = 0.54），平均血红蛋白值相似（13.4 对 13.3，p = 0.6）。与 NHANES 中的男性和女性患者相比，PWAWG 患者的 BMI、叶酸和平均血红蛋白值较低。男性和女性 PWAWG 患者的高血压患病率均较低。
虽然 CD 和 PWAWG 之间存在一些相似之处，这些相似之处可能归因于共同的 HLA 单倍型或无麸质饮食的影响，但这些患者中常见其他诊断。就 BMI 较低和高血压患病率较低而言，PWAWG 患者的心血管特征与 CD 患者相似。
