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儿童乳糜泻的 gluten-free 饮食依从性。

Adherence to Gluten-Free Diet in Children with Celiac Disease.

机构信息

Department of Pediatric Diseases and Pediatric Nursing, Clinic of Pediatrics, Gastrology and Childrens Rheumatology, Pomeranian Medical University, 71-454 Szczecin, Poland.

Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 71-454 Szczecin, Poland.

出版信息

Nutrients. 2018 Oct 4;10(10):1424. doi: 10.3390/nu10101424.

Abstract

Celiac disease (CD) can only be treated by rigorous life-long gluten-free diet (GFD). The study included 102 mothers and their CD children treated with GFD for at least two years. Frequency and cause of diet failure in children treated at present (54 children) and 10 years ago (48 children) were compared. Dietary adherence was evaluated serologically (tTG), while diet management difficulties were examined by means of a questionnaire. The study shows that one-third of patients fail to follow GFD, more often 10 years ago than now (40% vs. 26%; < 0.05), mainly children aged 13⁻18 (54% vs. 40% now; < 0.05). Younger children (up to 12) are less likely to abandon the diet (27% vs. 8%; < 0.05). In this age group non-intentional diet failure prevails, while teenagers interrupt their diet intentionally (45% vs. 33%; = ns (small population of children in this groups)). Currently, the most common causes of teenage diet failure are the absence of symptoms after consuming a small amount of gluten and, even more often, troublesome diet administration. Previously, the absence of peer acceptance prevailed. With this study we found that: 1. In West Pomerania, every fourth CD child does not follow GFD. 2. For years, teenagers have failed to follow GFD due to the absence of symptoms after consuming small amounts of gluten. 3. The incidence of non-intentional failure to follow GFD has significantly decreased over years, which indicates better dietary care.

摘要

乳糜泻(CD)只能通过严格的终生无麸质饮食(GFD)治疗。本研究纳入了 102 名接受 GFD 治疗至少两年的母亲及其 CD 患儿。比较了目前(54 名患儿)和 10 年前(48 名患儿)治疗的患儿饮食失败的频率和原因。通过酶联免疫吸附试验(tTG)检测患儿的饮食依从性,通过问卷调查评估患儿饮食管理的困难程度。研究表明,三分之一的患儿无法坚持 GFD,10 年前比现在更常见(40%比 26%;<0.05),主要是 13-18 岁的患儿(54%比 40%现在;<0.05)。年龄较小的患儿(12 岁以下)不太可能放弃饮食(27%比 8%;<0.05)。在这个年龄组,非故意的饮食失败更为常见,而青少年则故意中断饮食(45%比 33%;=ns(该年龄组患儿人数较少))。目前,青少年饮食失败的最常见原因是摄入少量麸质后无症状,更常见的是饮食管理困难。此前,同伴不接受是主要原因。通过这项研究我们发现:1. 在西波美拉尼亚,每四个 CD 患儿中就有一个不遵循 GFD。2. 多年来,青少年因摄入少量麸质后无症状而未能坚持 GFD。3. 非故意不遵循 GFD 的发生率多年来显著下降,这表明饮食管理得到了改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/337c/6213886/1a2daeae2834/nutrients-10-01424-g001.jpg

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