Yerushalmy-Feler Anat, Tauman Riva, Derowe Ari, Averbuch Eran, Ben-Tov Amir, Weintraub Yael, Weiner Dror, Amir Achiya, Moran-Lev Hadar, Cohen Shlomi
Pediatric Gastroenterology Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
BMC Pediatr. 2018 Feb 7;18(1):35. doi: 10.1186/s12887-018-1039-5.
Enlarged tonsils and adenoids are the major etiology of obstructive sleep apnea (OSA) in children. Lymphatic hyperplasia is common to both OSA and celiac disease. We aimed to investigate the effect of a gluten-free diet on OSA symptoms in children with celiac disease.
Children with celiac disease aged 2-18 years were prospectively recruited before the initiation of a gluten-free diet. Children with negative celiac serology who underwent gastrointestinal endoscopies for other indications served as controls. All participants completed a validated OSA-related symptoms questionnaire and the pediatric sleep questionnaire (PSQ) at baseline and 6 months later.
Thirty-four children with celiac disease (mean age 6.6 ± 3.5 years) and 24 controls (mean age 7.3 ± 4.6 years, P = 0.5) were recruited. There were no significant differences in gender, body mass index or season at recruitment between the two groups. The rate of positive PSQ scores was higher (more OSA-related symptoms) in the control group compared to the celiac group, both at recruitment and at the 6-month follow-up (33.3% vs. 11.8%, P = 0.046, and 16.7% vs. 0, P = 0.014, respectively). PSQ scores improved significantly in both groups at the 6-month follow-up (P < 0.001 for both). Improvement was significantly higher in the celiac group compared to controls (0.1 ± 0.09 vs.0.06 ± 0.06, respectively, P = 0.04).
Children with celiac disease had fewer OSA-related symptoms than controls, but the degree of improvement following the initiation of a gluten-free diet was significantly higher. These findings suggest that a gluten-free diet may improve OSA-related symptoms in children with celiac disease.
扁桃体和腺样体肿大是儿童阻塞性睡眠呼吸暂停（OSA）的主要病因。淋巴组织增生在OSA和乳糜泻中都很常见。我们旨在研究无麸质饮食对乳糜泻患儿OSA症状的影响。
前瞻性招募2至18岁开始无麸质饮食前的乳糜泻患儿。因其他指征接受胃肠内镜检查且乳糜泻血清学检查阴性的儿童作为对照。所有参与者在基线时和6个月后完成一份经过验证的OSA相关症状问卷和儿童睡眠问卷（PSQ）。
招募了34名乳糜泻患儿（平均年龄6.6±3.5岁）和24名对照（平均年龄7.3±4.6岁，P = 0.5）。两组在招募时的性别、体重指数或季节方面无显著差异。在招募时和6个月随访时，对照组的PSQ阳性评分率（更多OSA相关症状）均高于乳糜泻组（分别为33.3%对11.8%，P = 0.046；16.7%对0，P = 0.014）。两组在6个月随访时PSQ评分均显著改善（两组均P < 0.001）。乳糜泻组的改善程度显著高于对照组（分别为0.1±0.09对0.06±0.06，P = 0.04）。
乳糜泻患儿的OSA相关症状比对照组少，但开始无麸质饮食后的改善程度显著更高。这些发现表明，无麸质饮食可能改善乳糜泻患儿的OSA相关症状。
