Ciaccio Edward J, Lewis Suzanne K, Biviano Angelo B, Iyer Vivek, Garan Hasan, Green Peter H
Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons, New York, NY 10032, United States.
Department of Medicine, Division of Cardiology, Columbia University College of Physicians and Surgeons, New York, NY 10032, United States.
World J Cardiol. 2017 Aug 26;9(8):652-666. doi: 10.4330/wjc.v9.i8.652.
Celiac disease (CD) is an autoimmune response to ingestion of gluten protein, which is found in wheat, rye, and barley grains, and results in both small intestinal manifestations, including villous atrophy, as well as systemic manifestations. The main treatment for the disease is a gluten-free diet (GFD), which typically results in the restoration of the small intestinal villi, and restoration of other affected organ systems, to their normal functioning. In an increasing number of recently published studies, there has been great interest in the occurrence of alterations in the cardiovascular system in untreated CD. Herein, published studies in which CD and cardiovascular terms appear in the title of the study were reviewed. The publications were categorized into one of several types: (1) articles (including cohort and case-control studies); (2) reviews and meta-analyses; (3) case studies (one to three patient reports); (4) letters; (5) editorials; and (6) abstracts (used when no full-length work had been published). The studies were subdivided as either heart or vascular studies, and were further characterized by the particular condition that was evident in conjunction with CD. Publication information was determined using the Google Scholar search tool. For each publication, its type and year of publication were tabulated. Salient information from each article was then compiled. It was determined that there has been a sharp increase in the number of CD - cardiovascular studies since 2000. Most of the publications are either of the type "article" or "case study". The largest number of documents published concerned CD in conjunction with cardiomyopathy (33 studies), and there have also been substantial numbers of studies published on CD and thrombosis (27), cardiovascular risk (17), atherosclerosis (13), stroke (12), arterial function (11), and ischemic heart disease (11). Based on the published research, it can be concluded that many types of cardiovascular issues can occur in untreated CD patients, but that most tend to resolve on a GFD, often in conjunction with the healing of small intestinal villous atrophy. However, in some cases the alterations are irreversible, underscoring the need for CD screening and treatment when cardiovascular issues arise of unknown etiology.
乳糜泻(CD)是对摄入麸质蛋白产生的自身免疫反应,麸质蛋白存在于小麦、黑麦和大麦谷物中,会导致小肠表现,包括绒毛萎缩,以及全身表现。该疾病的主要治疗方法是无麸质饮食(GFD),这通常会使小肠绒毛恢复,并使其他受影响的器官系统恢复正常功能。在最近发表的越来越多的研究中,人们对未经治疗的CD患者心血管系统的改变越来越感兴趣。在此,对标题中出现CD和心血管术语的已发表研究进行了综述。这些出版物被分为几种类型之一:(1)文章(包括队列研究和病例对照研究);(2)综述和荟萃分析;(3)病例研究(1至3例患者报告);(4)信函;(5)社论;(6)摘要(在没有全文发表时使用)。这些研究细分为心脏或血管研究,并根据与CD相关的特定情况进一步分类。使用谷歌学术搜索工具确定出版信息。为每篇出版物列出其类型和出版年份。然后汇总每篇文章的重要信息。确定自2000年以来,CD-心血管研究的数量急剧增加。大多数出版物类型为“文章”或“病例研究”。发表的文献数量最多的是关于CD合并心肌病(33项研究),也有大量关于CD与血栓形成(27项)、心血管风险(17项)、动脉粥样硬化(13项)、中风(12项)、动脉功能(11项)和缺血性心脏病(11项)的研究。根据已发表的研究,可以得出结论,未经治疗的CD患者可能会出现多种心血管问题,但大多数问题在采用GFD治疗时往往会得到解决,通常伴随着小肠绒毛萎缩的愈合。然而,在某些情况下,这些改变是不可逆的,这突出了在出现病因不明的心血管问题时进行CD筛查和治疗的必要性。