Section of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari (Italy), Piazza G. Cesare 11, 70124 Bari, Italy.
Section of Pathology, Department of Emergency and Organ Transplantation, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
Nutrients. 2018 Dec 18;10(12):2001. doi: 10.3390/nu10122001.
Non-celiac gluten sensitivity (NCGS) is an emerging gluten-related condition. We investigated whether the presence of autoimmune stigmata in a group of patients with clinical suspicion of NCGS and a histological picture of microscopic enteritis (ME) could be a predictive factor of NCGS. Patients with ME were followed up by periodical examinations. At baseline, we collected data about previous clinical history, including autoimmune diseases. NCGS was diagnosed according to Salerno criteria; other causes of ME were diagnosed according to well-established protocols. Patients with celiac disease were excluded. Student's and chi-square tests were used in univariate analysis. Kaplan-Meier curves and Cox regression were used to estimate hazard ratios (HR). Sixty-three patients were included. Twenty-two had a final diagnosis of NCGS; the remaining 41 had non-gluten-related causes of ME. Prevalence of autoimmune thyroiditis was higher among NCGS patients (40.1%) than in other ME (14.6%; = 0.03). NCGS showed higher positivity rate for anti-gliadin (27.3% versus 2.5%; = 0.006) and anti-nucleus (45.4% versus 12.2%; = 0.005). Autoimmune thyroiditis had a non-significant trend ( = 0.06) for NCGS diagnosis, (HR = 2.4). Both anti-gliadin (HR = 2.4; = 0.04) and anti-nucleus (HR = 2.7; = 0.04) were directly associated with NCGS diagnosis. In conclusion, NCGS may have a cohort of autoimmune stigmata that can precede its diagnosis.
非乳糜泻麸质敏感性(NCGS)是一种新兴的与麸质相关的疾病。我们研究了一组临床疑似 NCGS 且组织学表现为显微镜下肠炎(ME)的患者中是否存在自身免疫迹象,这是否可作为 NCGS 的预测因素。ME 患者接受定期检查。在基线时,我们收集了有关既往临床病史的数据,包括自身免疫性疾病。根据萨勒诺标准诊断 NCGS;根据既定方案诊断其他 ME 的原因。排除乳糜泻患者。使用学生 t 检验和卡方检验进行单因素分析。使用 Kaplan-Meier 曲线和 Cox 回归估计风险比(HR)。共纳入 63 例患者。22 例最终诊断为 NCGS;其余 41 例 ME 有非麸质相关原因。NCGS 患者的自身免疫性甲状腺炎患病率(40.1%)高于其他 ME(14.6%; = 0.03)。NCGS 抗麸质(27.3%与 2.5%; = 0.006)和抗核抗体(45.4%与 12.2%; = 0.005)的阳性率更高。自身免疫性甲状腺炎对 NCGS 诊断的趋势有一定意义( = 0.06;HR = 2.4)。抗麸质(HR = 2.4; = 0.04)和抗核抗体(HR = 2.7; = 0.04)均与 NCGS 诊断直接相关。总之,NCGS 可能有一系列自身免疫特征,这些特征可能在其诊断之前出现。