Gastroenterology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Epidemiology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Digestion. 2019;100(4):262-268. doi: 10.1159/000495749. Epub 2018 Dec 14.
Many investigations have demonstrated that changes in body weight are frequent in patients with coeliac disease (CD) after a gluten-free diet (GFD); conversely data on the metabolic syndrome (MS) and hepatic steatosis (HS) are still rare. The aim is to evaluate the prevalence of MS and HS in patients with CD, before and after a GFD.
One hundred eighty-five coeliac adult patients were enrolled in the study. Diagnosis of MS was made according to the current international criteria including waist circumference (WC), hypertension, reduction of high-density lipoprotein (HDL) cholesterol, hypertriglyceridemia, and hyperglycemia. Body mass index (BMI), hypercholesterolemia, and HS were also assessed.
CD patients showed an increased risk of developing both MS and HS after following a GFD. MS was reported in 3.24% of the cases at the time of CD diagnosis and in 14.59% after GFD (p < 0.0001). HS was reported in 1.7% at the time of diagnosis and in 11.1% after GFD (p < 0.0001). With regard to metabolic sub-categories, the prevalence of the increase in WC, hypertension, reduction of HDL cholesterol, hyperglycemia, hypercholesterolemia, and BMI > 25 was significantly higher after GFD compared to baseline at CD diagnosis.
In CD patients, following a GFD maybe can contribute to the development of MS and HS. Patients should be informed about this possible risk.
许多研究表明,在接受无麸质饮食(GFD)后,乳糜泻(CD)患者的体重变化很常见;相反,关于代谢综合征(MS)和肝脂肪变性(HS)的数据仍然很少。本研究旨在评估 CD 患者在接受 GFD 前后 MS 和 HS 的患病率。
本研究纳入了 185 例成年乳糜泻患者。MS 的诊断采用目前的国际标准,包括腰围(WC)、高血压、高密度脂蛋白(HDL)胆固醇降低、高甘油三酯血症和高血糖。还评估了体重指数(BMI)、高胆固醇血症和 HS。
CD 患者在接受 GFD 后发生 MS 和 HS 的风险增加。CD 诊断时 MS 的患病率为 3.24%,GFD 后为 14.59%(p<0.0001)。诊断时 HS 的患病率为 1.7%,GFD 后为 11.1%(p<0.0001)。在代谢亚类方面,与 CD 诊断时基线相比,GFD 后 WC 增加、高血压、HDL 胆固醇降低、高血糖、高胆固醇血症和 BMI>25 的患病率显著增加。
在 CD 患者中,遵循 GFD 可能会导致 MS 和 HS 的发生。应告知患者这种可能的风险。