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非乳糜泻性小麦敏感患者的低骨矿物质密度和低体重指数风险:一项前瞻性观察研究。

Risk of low bone mineral density and low body mass index in patients with non-celiac wheat-sensitivity: a prospective observation study.

作者信息

Carroccio Antonio, Soresi Maurizio, D'Alcamo Alberto, Sciumè Carmelo, Iacono Giuseppe, Geraci Girolamo, Brusca Ignazio, Seidita Aurelio, Adragna Floriana, Carta Miriam, Mansueto Pasquale

出版信息

BMC Med. 2014 Nov 28;12:230. doi: 10.1186/s12916-014-0230-2.


DOI:10.1186/s12916-014-0230-2
PMID:25430806
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4265355/
Abstract

BACKGROUND: Non-celiac gluten sensitivity (NCGS) or 'wheat sensitivity' (NCWS) is included in the spectrum of gluten-related disorders. No data are available on the prevalence of low bone mass density (BMD) in NCWS. Our study aims to evaluate the prevalence of low BMD in NCWS patients and search for correlations with other clinical characteristics. METHODS: This prospective observation study included 75 NCWS patients (63 women; median age 36 years) with irritable bowel syndrome (IBS)-like symptoms, 65 IBS and 50 celiac controls. Patients were recruited at two Internal Medicine Departments. Elimination diet and double-blind placebo controlled (DBPC) wheat challenge proved the NCWS diagnosis. All subjects underwent BMD assessment by Dual Energy X-Ray Absorptiometry (DXA), duodenal histology, HLA DQ typing, body mass index (BMI) evaluation and assessment for daily calcium intake. RESULTS: DBPC cow's milk proteins challenge showed that 30 of the 75 NCWS patients suffered from multiple food sensitivity. Osteopenia and osteoporosis frequency increased from IBS to NCWS and to celiac disease (CD) (P <0.0001). Thirty-five NCWS patients (46.6%) showed osteopenia or osteoporosis. Low BMD was related to low BMI and multiple food sensitivity. Values of daily dietary calcium intake in NCWS patients were significantly lower than in IBS controls. CONCLUSIONS: An elevated frequency of bone mass loss in NCWS patients was found; this was related to low BMI and was more frequent in patients with NCWS associated with other food sensitivity. A low daily intake of dietary calcium was observed in patients with NCWS.

摘要

背景:非乳糜泻性麸质敏感(NCGS)或“小麦敏感”(NCWS)属于麸质相关疾病范畴。目前尚无关于NCWS患者低骨密度(BMD)患病率的数据。我们的研究旨在评估NCWS患者中低BMD的患病率,并寻找其与其他临床特征的相关性。 方法:这项前瞻性观察研究纳入了75例有肠易激综合征(IBS)样症状的NCWS患者(63名女性;中位年龄36岁)、65例IBS患者和50例乳糜泻对照。患者在两个内科招募。排除饮食和双盲安慰剂对照(DBPC)小麦激发试验证实了NCWS诊断。所有受试者均接受双能X线吸收法(DXA)进行BMD评估、十二指肠组织学检查、HLA DQ分型、体重指数(BMI)评估以及每日钙摄入量评估。 结果:DBPC牛奶蛋白激发试验显示,75例NCWS患者中有30例患有多种食物敏感。骨质减少和骨质疏松的发生率从IBS到NCWS再到乳糜泻(CD)逐渐升高(P<0.0001)。35例NCWS患者(46.6%)表现为骨质减少或骨质疏松。低BMD与低BMI和多种食物敏感有关。NCWS患者的每日膳食钙摄入量显著低于IBS对照。 结论:发现NCWS患者骨质流失频率升高;这与低BMI有关,在伴有其他食物敏感的NCWS患者中更常见。观察到NCWS患者每日膳食钙摄入量较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6e6/4265355/e236d1f2001e/12916_2014_230_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6e6/4265355/5d3d0528184b/12916_2014_230_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6e6/4265355/892a504bea43/12916_2014_230_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6e6/4265355/e236d1f2001e/12916_2014_230_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6e6/4265355/5d3d0528184b/12916_2014_230_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6e6/4265355/892a504bea43/12916_2014_230_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6e6/4265355/e236d1f2001e/12916_2014_230_Fig3_HTML.jpg

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本文引用的文献

[1]
An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity.

BMC Med. 2014-5-23

[2]
Characteristics of patients who avoid wheat and/or gluten in the absence of Celiac disease.

Dig Dis Sci. 2013-12-28

[3]
Non-celiac wheat sensitivity is a more appropriate label than non-celiac gluten sensitivity.

Gastroenterology. 2014-1

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A UK study assessing the population prevalence of self-reported gluten sensitivity and referral characteristics to secondary care.

Eur J Gastroenterol Hepatol. 2014-1

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Non-celiac wheat sensitivity as an allergic condition: personal experience and narrative review.

Am J Gastroenterol. 2013-11-5

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Non-Celiac Gluten sensitivity: the new frontier of gluten related disorders.

Nutrients. 2013-9-26

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A diet low in FODMAPs reduces symptoms of irritable bowel syndrome.

Gastroenterology. 2013-9-25

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Neurogastroenterol Motil. 2013-8-12

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Scand J Gastroenterol. 2013-8

[10]
No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates.

Gastroenterology. 2013-5-4

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