Uspenskaya I D, Erzutova M V, Korkotashvili L V, Kolesov S A, Shirokova N Y
Bratisl Lek Listy. 2014;115(11):712-7. doi: 10.4149/bll_2014_138.
The aim of the study was to determine serum nitric oxide (NO) metabolites and correlate them to gluten-free diet (GFD) compliance, the parameters of morphological and functional condition of the small intestine in patients with celiac disease (CD) in a long-term follow-up.
The study included 35 children (age median 8.0 years) with previously diagnosed CD, among them 15 - on a strict GFD and 20 - on a semistrict GFD. 32 patients (age median 7.5 years) with functional abdominal pain were recruited as controls. Nitrites (NO(2)), nitrates (NO(3)), total content of nitrites and nitrates (NOx) in serum were determined using the Griess reaction. CD patients underwent small intestine morphometry and absorption D-xylose test.
Compared to the controls, the CD patients on a strict GFD had no significant differences in NO(2), NO(3), NOx content, while in patients violating GFD these parameters were significantly higher. In comparison with the patients on a strict GFD, the patients on a semistrict GFD had higher median values of NO(3) (p = 0.002) and NOx (p = 0.0000). Serum NOx correlated negatively with the height of villi (p = 0.0001), D-xylose excretion (p = 0.0063), and correlated positively with the depth of crypts (p = 0.0082) and cellular density of villi stroma (p = 0.0067).
CD patients not keeping to a strict GFD have an increased level of nitric oxide metabolites in serum. NOx content is associated with morphometric parameters of the small intestine that proves the participation of NO in the pathogenesis of histological changes in CD (Tab. 3, Ref. 39).
本研究旨在测定血清一氧化氮（NO）代谢产物，并将其与乳糜泻（CD）患者长期随访中无麸质饮食（GFD）依从性、小肠形态和功能状况参数相关联。
本研究纳入35例先前诊断为CD的儿童（年龄中位数8.0岁），其中15例严格遵循GFD，20例遵循半严格GFD。招募32例功能性腹痛患者（年龄中位数7.5岁）作为对照。采用格里斯反应测定血清中亚硝酸盐（NO₂）、硝酸盐（NO₃）、亚硝酸盐和硝酸盐总含量（NOx）。CD患者接受小肠形态测量和吸收木糖试验。
与对照组相比，严格遵循GFD的CD患者NO₂、NO₃、NOx含量无显著差异，而未遵循GFD的患者这些参数显著更高。与严格遵循GFD的患者相比，半严格遵循GFD的患者NO₃中位数（p = 0.002）和NOx中位数（p = 0.0000）更高。血清NOx与绒毛高度呈负相关（p = 0.0001）、与木糖排泄呈负相关（p = 0.0063），与隐窝深度呈正相关（p = 0.0082）以及与绒毛基质细胞密度呈正相关（p = 0.0067）。
未严格遵循GFD的CD患者血清中一氧化氮代谢产物水平升高。NOx含量与小肠形态测量参数相关，这证明NO参与了CD组织学变化的发病机制（表3，参考文献39）。
