Department of Medicine, Rutgers New Jersey Medical School, University Hospital, Newark, NJ.
Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX.
J Clin Gastroenterol. 2019 Nov/Dec;53(10):e416-e423. doi: 10.1097/MCG.0000000000001100.
We analyzed demographics, lifestyle patterns, and clinical characteristics of people with celiac disease (CD) and people without CD avoiding gluten (PWAG) to better understand associations with medical conditions and consumer behavior.
Clinical significance of CD and gluten avoidance in the general population is incompletely understood. Recently, a high incidence of CD in adolescents with susceptibility genotypes, similar to other autoimmune or allergic disorders, and regional differences in consumer practices of gluten avoidance were reported.
Among 22,277 participants in the National Health and Nutrition Examination Survey 2009-2014, we identified persons with CD by testing CD serology or by both a health care provider diagnosis and adherence to a gluten-free diet. Similarly, PWAG were defined as adherent to a gluten-free diet without a CD diagnosis. Consumer behavior and characteristics of both groups, CD and PWAG were compared with those without these conditions, using survey-weighted generalized logistic regression.
Participants with CD considered nutrition very important when grocery shopping and tended to have more constipation and thyroid disease. PWAG tended to spend more money on groceries, purchase organic foods, and check food labels more frequently during grocery shopping. They also reported having more food allergies, asthma, and thyroid disease.
Our study confirms that CD and PWAG share comorbidities of autoimmune nature. PWAG had more autoimmune/allergy-related disorders that may be associated with non-celiac gluten sensitivity a self-justifiable reason to be on the diet.
我们分析了乳糜泻(CD)患者和避免食用 gluten 的无 CD 人群(PWAG)的人口统计学、生活方式模式和临床特征,以更好地了解与医疗状况和消费者行为的关联。
CD 和普通人群中 gluten 回避的临床意义尚不完全清楚。最近,有报道称,易感基因型的青少年中 CD 的发病率较高,类似于其他自身免疫或过敏疾病,以及 gluten 回避的消费者行为存在地区差异。
在 2009-2014 年的国家健康和营养调查 22277 名参与者中,我们通过检测 CD 血清学或通过医疗保健提供者的诊断和 gluten 自由饮食的依从性来识别 CD 患者。同样,PWAG 被定义为遵循 gluten 自由饮食但没有 CD 诊断。使用调查加权广义逻辑回归比较两组(CD 和 PWAG)和无这些条件的消费者行为和特征。
CD 患者在购物时认为营养非常重要,并且往往更容易便秘和患有甲状腺疾病。PWAG 往往在杂货上花费更多,购买有机食品,并且在购物时更频繁地检查食品标签。他们还报告有更多的食物过敏、哮喘和甲状腺疾病。
我们的研究证实,CD 和 PWAG 具有自身免疫性质的共病。PWAG 有更多的自身免疫/过敏相关疾病,可能与非乳糜泻麸质敏感性有关,这是遵循饮食的自我合理化理由。