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食用藜麦(Chenopodium quinoa Willd.)对乳糜泻患者的胃肠道影响。

Gastrointestinal effects of eating quinoa (Chenopodium quinoa Willd.) in celiac patients.

机构信息

King's College London, Division of Diabetes and Nutritional Sciences, Department of Gastroenterology, The Rayne Institute (KCL), Gastroenterology Laboratory, London, UK.

Departamento de Producción Vegetal, Universidad Politécnica de Madrid, Spain.

出版信息

Am J Gastroenterol. 2014 Feb;109(2):270-8. doi: 10.1038/ajg.2013.431. Epub 2014 Jan 21.

Abstract

OBJECTIVES

Celiac disease is an enteropathy triggered by dietary gluten found in wheat, rye, and barley. Treatment involves a strict gluten-free diet (GFD). Quinoa is a highly nutritive plant from the Andes that has been recommended as part of a GFD. However, in-vitro data suggested that quinoa prolamins can stimulate innate and adaptive immune responses in celiac patients. Therefore, we aimed to evaluate the in-vivo effects of eating quinoa in adult celiac patients.

METHODS

Nineteen treated celiac patients consumed 50 g of quinoa every day for 6 weeks as part of their usual GFD. We evaluated diet, serology, and gastrointestinal parameters. Furthermore, we carried out detail histological assessment of 10 patients before and after eating quinoa.

RESULTS

Gastrointestinal parameters were normal. The ratio of villus height to crypt depth improved from slightly below normal values (2.8:1) to normal levels (3:1), surface-enterocyte cell height improved from 28.76 to 29.77 μm and the number of intra-epithelial lymphocytes per 100 enterocytes decreased from 30.3 to 29.7. Median values for all the blood tests remained within normal ranges, although total cholesterol (n=19) decreased from 4.6 to 4.3 mmol/l, low-density lipoprotein decreased from 2.46 to 2.45 mmol/l, high-density lipoprotein decreased from 1.8 to 1.68 mmol/l and triglycerides decreased from 0.80 to 0.79 mmol/l.

CONCLUSIONS

Addition of quinoa to the GFD of celiac patients was well tolerated and did not exacerbate the condition. There was a positive trend toward improved histological and serological parameters, particularly a mild hypocholesterolemic effect. Overall, this is the first clinical data suggesting that daily 50 g of quinoa for 6 weeks can be safely tolerated by celiac patients. However, further studies are needed to determine the long-term effects of quinoa consumption.

摘要

目的

乳糜泻是一种由小麦、黑麦和大麦中存在的膳食麸质引发的肠病。治疗包括严格的无麸质饮食(GFD)。藜麦是一种来自安第斯山脉的高营养植物,已被推荐作为 GFD 的一部分。然而,体外数据表明,藜麦醇溶蛋白可以刺激乳糜泻患者的固有和适应性免疫反应。因此,我们旨在评估成年乳糜泻患者食用藜麦的体内影响。

方法

19 名接受治疗的乳糜泻患者在他们的常规 GFD 中每天食用 50 克藜麦,为期 6 周。我们评估了饮食、血清学和胃肠道参数。此外,我们对 10 名患者在食用藜麦前后进行了详细的组织学评估。

结果

胃肠道参数正常。绒毛高度与隐窝深度的比值从略低于正常值(2.8:1)改善至正常水平(3:1),表面肠细胞高度从 28.76μm 增加至 29.77μm,每个上皮细胞内淋巴细胞的数量从 30.3 个减少至 29.7 个。所有血液测试的中位数值仍在正常范围内,尽管总胆固醇(n=19)从 4.6mmol/L 降至 4.3mmol/L,低密度脂蛋白从 2.46mmol/L 降至 2.45mmol/L,高密度脂蛋白从 1.8mmol/L 降至 1.68mmol/L,甘油三酯从 0.80mmol/L 降至 0.79mmol/L。

结论

将藜麦添加到乳糜泻患者的 GFD 中是可以耐受的,并且不会加重病情。组织学和血清学参数有改善的趋势,特别是轻度降胆固醇作用。总的来说,这是第一项临床数据表明,6 周内每天食用 50 克藜麦可以被乳糜泻患者安全耐受。然而,还需要进一步的研究来确定藜麦消费的长期影响。

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