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对牛奶和小麦的不耐受感是否与相应的IgG和IgA食物抗体有关?一项针对病态肥胖和胃肠道症状患者的横断面研究。

Is perceived intolerance to milk and wheat associated with the corresponding IgG and IgA food antibodies? A cross sectional study in subjects with morbid obesity and gastrointestinal symptoms.

作者信息

Kvehaugen Anne Stine, Tveiten Dag, Farup Per G

机构信息

Department of Surgery, Innlandet Hospital Trust, Kyrre Greppsgate 11, 2819, Gjøvik, Norway.

Lab1 AS, Sandvika, Norway.

出版信息

BMC Gastroenterol. 2018 Jan 30;18(1):22. doi: 10.1186/s12876-018-0750-x.

Abstract

BACKGROUND

Serum IgG and IgA food antibodies have been used for dietary advice to subjects with gastrointestinal symptoms and perceived food intolerance, but the role of these antibodies in mediating intolerance is controversial. The present study investigated associations between perceived gastrointestinal intolerance to milk-or wheat and the corresponding s-IgG and s-IgA food antibodies in subjects with morbid obesity.

METHODS

Subjects with morbid obesity (BMI ≥ 40 kg/m or ≥35 kg/m with obesity-related complications) were included. Irritable Bowel Syndrome (IBS) was diagnosed based on the Rome III criteria. Severity of specific gastrointestinal symptoms were measured with the Gastrointestinal Symptom Rating Scale (GSRS)-IBS. S-IgG against cow's milk, cheese, wheat and gluten, and s-IgA against casein and gliadin were measured.

RESULTS

Ninety-seven subjects (80 females) with mean age 45 (SD 8.4) years were included, 70 had gastrointestinal complaints, 25 had IBS, and 22 and 20 reported milk- and wheat- intolerance respectively. There were no significant differences in serum concentrations or proportions of subjects above defined cut-off values for the antibodies between subjects with and without gastrointestinal complaints. In the group with gastrointestinal complaints, no significant differences were found between subjects with and without perceived food intolerance. Except for a significant correlation between IgG against cheese and GSRS-diarrhea (Rho: -0.25, P = 0.04), no significant correlations were found between the antibodies and type or degree of gastrointestinal symptoms, including IBS.

CONCLUSIONS

The study showed no associations between perceived milk or wheat intolerance and the corresponding s-IgG and s-IgA food antibodies in subjects with morbid obesity.

摘要

背景

血清IgG和IgA食物抗体已被用于为有胃肠道症状和感觉有食物不耐受的受试者提供饮食建议,但这些抗体在介导不耐受中的作用存在争议。本研究调查了病态肥胖受试者中感觉对牛奶或小麦的胃肠道不耐受与相应的s-IgG和s-IgA食物抗体之间的关联。

方法

纳入病态肥胖受试者(BMI≥40kg/m²或≥35kg/m²且有肥胖相关并发症)。根据罗马III标准诊断肠易激综合征(IBS)。用胃肠道症状评分量表(GSRS)-IBS测量特定胃肠道症状的严重程度。检测针对牛奶、奶酪、小麦和麸质的s-IgG,以及针对酪蛋白和麦醇溶蛋白的s-IgA。

结果

纳入97名受试者(80名女性),平均年龄45(标准差8.4)岁,70名有胃肠道不适,25名患有IBS,分别有22名和20名报告有牛奶和小麦不耐受。有胃肠道不适和无胃肠道不适的受试者之间,血清浓度或抗体高于定义临界值的受试者比例无显著差异。在有胃肠道不适的组中,感觉有食物不耐受和无食物不耐受的受试者之间未发现显著差异。除了针对奶酪的IgG与GSRS-腹泻之间存在显著相关性(Rho: -0.25,P = 0.04)外,抗体与胃肠道症状的类型或程度(包括IBS)之间未发现显著相关性。

结论

该研究表明,病态肥胖受试者中感觉的牛奶或小麦不耐受与相应的s-IgG和s-IgA食物抗体之间无关联。

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