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麸质无饮食 6 个月后乳糜泻患者、非乳糜泻麸质敏感患者和无症状对照者的代谢变化。

Metabolic effects in patients with celiac disease, patients with nonceliac gluten sensitivity, and asymptomatic controls, after six months of a gluten-free diet.

机构信息

Laboratorio de Fisiología Digestiva y Motilidad Gastrointestinal, Instituto de Investigaciones Medico-Biológicas, Universidad Veracruzana, Veracruz, México.

Laboratorio de Fisiología Digestiva y Motilidad Gastrointestinal, Instituto de Investigaciones Medico-Biológicas, Universidad Veracruzana, Veracruz, México.

出版信息

Rev Gastroenterol Mex (Engl Ed). 2020 Apr-Jun;85(2):109-117. doi: 10.1016/j.rgmx.2019.02.002. Epub 2019 Apr 15.

Abstract

INTRODUCTION AND OBJECTIVES

It is essential for patients with celiac disease (CD) to be on a gluten-free diet (GFD) but said diet has also been reported to increase the risk for metabolic syndrome. There is no evidence on the metabolic effects of a GFD in patients with nonceliac gluten sensitivity (NCGS) or in asymptomatic subjects. Therefore, the aim of the present study was to evaluate the metabolic effects of a GFD over a 6-month period in patients with CD, patients with NCGS, and in asymptomatic controls (ACs).

MATERIALS AND METHODS

A prospective study was conducted that evaluated metabolic syndrome and its components of obesity, high blood pressure, hepatic steatosis, and hyperglycemia at the baseline and at 6 months.

RESULTS

A total of 66 subjects (22 CD, 22 NCGS, and 22 AC) were included in the study. At the baseline, 10% of the patients with CD presented with obesity, high blood pressure, hepatic steatosis, and metabolic syndrome. After 6 months, obesity and metabolic syndrome increased by 20% (p=0.125). In the patients with NCGS, obesity increased by 5% after the GFD and 20% of those patients presented with de novo hepatic steatosis. The prevalence of obesity decreased by 10% in the controls after the GFD (30 vs 20%, p=0.5) and none of the other components of metabolic syndrome were affected.

CONCLUSIONS

The metabolic benefits and risks of a GFD should be considered when prescribing said diet in the different populations that opt for that type of intervention.

摘要

简介和目的

乳糜泻(CD)患者必须采用无麸质饮食(GFD),但该饮食也被报道会增加代谢综合征的风险。非乳糜泻麸质敏感性(NCGS)患者或无症状受试者采用 GFD 的代谢影响尚无证据。因此,本研究旨在评估 CD 患者、NCGS 患者和无症状对照者(ACs)采用 GFD 治疗 6 个月的代谢影响。

材料和方法

进行了一项前瞻性研究,评估了基线和 6 个月时代谢综合征及其肥胖、高血压、肝脂肪变性和高血糖的组成部分。

结果

共有 66 名受试者(22 名 CD、22 名 NCGS 和 22 名 AC)纳入了本研究。在基线时,10%的 CD 患者存在肥胖、高血压、肝脂肪变性和代谢综合征。6 个月后,肥胖和代谢综合征增加了 20%(p=0.125)。在 NCGS 患者中,GFD 后肥胖增加了 5%,20%的患者出现新发性肝脂肪变性。在 GFD 后,对照组的肥胖患病率下降了 10%(30%对 20%,p=0.5),代谢综合征的其他组成部分不受影响。

结论

在不同人群中选择这种干预方式时,应考虑 GFD 的代谢益处和风险。

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