Vajpayee Shailja, Sharma Shiv Dayal, Gupta Rajkumar, Goyal Alok, Sharma Aakash
Department of Pediatric Medicine, Sir Padampat Mother and Child Health Institute, Swai Man Singh Medical College, Jaipur, India.
Pediatr Gastroenterol Hepatol Nutr. 2016 Dec;19(4):229-235. doi: 10.5223/pghn.2016.19.4.229. Epub 2016 Dec 28.
To study whether breastfeeding and breastfeeding status during gluten introduction influences the age at diagnosis of celiac disease (CD). In addition to study, whether the timing of gluten introduction influences the age at diagnosis of CD.
It was a hospital based observational study. Total 198 patients diagnosed with CD as per modified European Society of Pediatric Gastroenterology, Hepatology and Nutrition (2012) criteria, aged between 6 months to 6 years were included. Detail history taken with special emphasis on breastfeeding and age of gluten introduction. Standard statistical methods used to analyze the data.
Mean±standard deviation age of onset and diagnosis of CD in breastfed cases was 2.81±1.42 years and 3.68 ±1.55 years respectively as compared to 1.84±1.36 years and 2.70±1.65 years respectively in not breastfed cases (<0.05). Those who had continued breastfeeding during gluten introduction and of longer duration had significantly delayed onset of disease. The age at onset of CD was under one year in 40.42% of the cases, who had started gluten before 6 months of age compared to only 12.58% of those who had started gluten later (<0.001). The proposed statistical model showed that two variables, i.e., breast feeding status during gluten introduction and age at gluten introduction positively influencing the age at diagnosis of CD.
Delayed gluten introduction to infant's diet along with continuing breastfeeding, delays symptomatic CD. However, it is not clear from our study that these infant feeding practices provide permanent protection against the disease or merely delays the symptoms.
研究在引入麸质期间母乳喂养及母乳喂养状态是否会影响乳糜泻（CD）的诊断年龄。此外，研究引入麸质的时间是否会影响CD的诊断年龄。
这是一项基于医院的观察性研究。纳入了198例根据改良的欧洲儿科胃肠病、肝病和营养学会（2012年）标准诊断为CD的患者，年龄在6个月至6岁之间。详细记录病史，特别强调母乳喂养情况和引入麸质的年龄。使用标准统计方法分析数据。
母乳喂养患儿CD发病和诊断的平均±标准差年龄分别为2.81±1.42岁和3.68±1.55岁，而非母乳喂养患儿分别为1.84±1.36岁和2.70±1.65岁（<0.05）。在引入麸质期间持续母乳喂养且时间较长的患儿发病明显延迟。在6个月前开始引入麸质的患儿中，40.42%的CD发病年龄在1岁以下，而在较晚引入麸质的患儿中这一比例仅为12.58%（<0.001）。所提出的统计模型表明，两个变量，即引入麸质期间的母乳喂养状态和引入麸质的年龄，对CD的诊断年龄有正向影响。
在婴儿饮食中延迟引入麸质并持续母乳喂养，会延迟有症状的CD的出现。然而，从我们的研究中尚不清楚这些婴儿喂养方式是能提供对该疾病的永久保护还是仅仅延迟症状出现。
