Departments of Pediatrics, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
Departments of Pediatrics, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
Clin Nutr. 2018 Jun;37(3):1000-1004. doi: 10.1016/j.clnu.2017.04.010. Epub 2017 Apr 17.
BACKGROUND & AIMS: Compliance to a gluten free diet (GFD) in celiac disease (CD) is ideally assessed by dietary interviews, albeit time-consuming. Short dietary questionnaires have been developed for adults but not for children. Primary aim was to compare GFD compliance in celiac children, measured by a short dietary questionnaire against a dietary interview. Secondary aims were correlation between both questionnaires and celiac antibodies and identifying variables predicting noncompliance.
Between 2012 and 2014, participants in the E-health CoelKids study, completed a short dietary questionnaire and standardized dietary interview together with measurement of anti-tissue transglutaminase antibodies (TG2A). Results of the questionnaires were assigned under similar categories. Factors possibly influencing dietary compliance were recorded. Where appropriate, Pearson's Chi-square test for trend, unpaired t-test, Cohen's kappa and one-way ANOVA were used.
151 of 165 participating patients were studied, 66% were female. Mean age was 11.3 years (2-26, SD 5.4), mean age at CD diagnosis was 4.9 years (1-23, SD 4.0). The short questionnaire and dietary interview correlated poorly, detecting problems in dietary adherence in 14% and 52% of the patients, respectively (Cohen's kappa 0.034). Only the short questionnaire correlated with TG2A (p = 0.003). Only older age was associated with noncompliance, the mean age of completely nonadherent, adherent but committing errors, and strictly adherent patients were 15.5, 11.5 and 10.1 years, respectively (p < 0.001).
Compared to the dietary interview, short dietary questionnaires and TG2A serology failed to detect dietary transgressions in CD children, wherein adolescents were shown to be at highest risk.
在乳糜泻（CD）中，通过饮食访谈评估无麸质饮食（GFD）的依从性是理想的，尽管耗时。已经为成年人开发了简短的饮食问卷，但尚未为儿童开发。主要目的是通过与饮食访谈相比，比较通过简短饮食问卷测量的乳糜泻儿童的 GFD 依从性。次要目的是比较两种问卷与抗组织转谷氨酰胺酶抗体（TG2A）之间的相关性，并确定预测不依从的变量。
在 2012 年至 2014 年期间，参加电子健康 CoelKids 研究的参与者完成了简短的饮食问卷和标准化饮食访谈，同时测量了抗组织转谷氨酰胺酶抗体（TG2A）。问卷的结果被分配到类似的类别中。记录了可能影响饮食依从性的因素。在适当的情况下，使用 Pearson's Chi-square 检验趋势、未配对 t 检验、Cohen's kappa 和单因素方差分析。
151 名参与研究的患者中有 165 名完成了研究，66%为女性。平均年龄为 11.3 岁（2-26，SD 5.4），乳糜泻诊断年龄为 4.9 岁（1-23，SD 4.0）。简短问卷和饮食访谈相关性较差，分别检测到 14%和 52%的患者存在饮食依从问题（Cohen's kappa 0.034）。只有简短问卷与 TG2A 相关（p=0.003）。只有年龄较大与不依从有关，完全不依从、依从但犯错误和严格依从的患者的平均年龄分别为 15.5、11.5 和 10.1 岁（p<0.001）。
与饮食访谈相比，简短的饮食问卷和 TG2A 血清学无法检测到 CD 儿童的饮食违规行为，其中青少年的风险最高。
