Department of Public Health and Clinical Medicine, Family Medicine.
Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden.
J Pediatr Gastroenterol Nutr. 2019 Nov;69(5):575-580. doi: 10.1097/MPG.0000000000002451.
The aims of the study were to ascertain whether the Celiac Dietary Adherence Test (CDAT) could contribute in determining adherence to a gluten-free diet in patients with celiac disease and to evaluate the diet adherence and well being of a study population 5 years after a celiac disease screening known as "Exploring the Iceberg of Celiacs in Sweden."
Through the screening, 90 adolescents (born 1997) were diagnosed with biopsy-proven celiac disease at 12 years of age. Of them, 70 (78%) came to a 5-year follow-up where anti-tissue transglutaminase antibodies 2 was tested and a questionnaire was filled in, including CDAT, which consists of 7 questions related to adherence. Nonparametrical tests were used to determine associations between adherence measures.
Among the adolescents, 86% were adherent to a gluten-free diet 5 years after screening, 38% reported their general well being as excellent, 50% very well, and 12% well. Statistically significant associations were seen between anti-tissue transglutaminase antibodies 2 and the CDAT score (P = 0.033), and the self-reported adherence question and the CDAT score (P < 0.001).
The screening-detected adolescents reported a high level of well being and adherence to a gluten-free diet 5 years after screening. We conclude that the CDAT can be used in clinical practice as an estimation of adherence to a gluten-free diet. It would be most suitable to use in conjunction with currently used adherence measures, but can also be used as a stand-alone method when others are not accessible.
本研究旨在确定乳糜泻饮食依从性测试（CDAT）是否有助于确定乳糜泻患者对无麸质饮食的依从性，并评估在一项名为“探索瑞典乳糜泻冰山”的乳糜泻筛查 5 年后研究人群的饮食依从性和健康状况。
通过筛查，90 名（1997 年出生）青少年在 12 岁时被诊断出患有活检证实的乳糜泻。其中，70 人（78%）接受了为期 5 年的随访，检测了抗组织转谷氨酰胺酶抗体 2，并填写了一份问卷，包括与依从性相关的 7 个问题的 CDAT。采用非参数检验来确定依从性测量之间的关联。
在这些青少年中，86%的人在筛查后 5 年仍坚持无麸质饮食，38%报告他们的总体健康状况为极好，50%为很好，12%为良好。抗组织转谷氨酰胺酶抗体 2 与 CDAT 评分之间存在统计学显著关联（P = 0.033），以及自我报告的依从性问题与 CDAT 评分之间存在统计学显著关联（P < 0.001）。
筛查发现的青少年在筛查后 5 年报告了较高的健康水平和对无麸质饮食的依从性。我们得出结论，CDAT 可在临床实践中用于估计对无麸质饮食的依从性。它最适合与目前使用的依从性测量方法一起使用，但在无法获得其他方法时，也可以单独使用。
