Miró Marta, Alonso-Garrido Manuel, Lozano Manuel, Peiró Juanjo, Manyes Lara
Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine Department, Universitat de València, Valencia, Spain.
Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain.
Heliyon. 2021 Apr 1;7(4):e06642. doi: 10.1016/j.heliyon.2021.e06642. eCollection 2021 Apr.
In clinical practice, celiac disease (CD) is monitored through anti-transglutaminase (TGA-IgA) antibody levels. The normalization of serum levels in successive periodic measurements indicates good response and adherence to dietary treatment.
To evaluate the factors associated with the evolution of TGA-IgA antibodies and their association with dietary non-compliance and diseases related to CD.
This prospective observational study was carried out in 254 participants, who were recruited from patients from a hospital in southern Spain. Information about sex, age, serological test results, HLA DQ2/DQ8 haplotypes, mucosal atrophy, gastrointestinal and extra-intestinal symptoms, as well as diagnosis of diseases related to CD, was collected.
Clinical manifestations, such as diarrhoea, abdominal pain and weight loss, showed differences according to sex and age. Children under 18 years of age presented a degree of total or severe atrophy of the intestinal villi. TGA-IgA antibodies concentrations were directly associated with the number of digestive disorders manifested by the patient and the record of dietary non-compliance and inversely related to the number of extra-digestive disorders.
Adolescents between 12 and 18 years old were the least monitored as well as the group with more extra-intestinal symptoms reported. Therefore, it is necessary to develop strategies in clinical practice aimed at this population group and continuous monitoring should be implemented to improve life quality and reduce complications that may arise in the long term.
在临床实践中，通过抗转谷氨酰胺酶（TGA-IgA）抗体水平来监测乳糜泻（CD）。连续定期测量中血清水平的正常化表明对饮食治疗有良好反应且依从性良好。
评估与TGA-IgA抗体演变相关的因素及其与饮食不依从和与CD相关疾病的关联。
这项前瞻性观察性研究在254名参与者中进行，这些参与者从西班牙南部一家医院的患者中招募。收集了有关性别、年龄、血清学检测结果、HLA DQ2/DQ8单倍型、黏膜萎缩、胃肠道和肠外症状以及与CD相关疾病诊断的信息。
腹泻、腹痛和体重减轻等临床表现因性别和年龄而异。18岁以下儿童出现了一定程度的小肠绒毛完全或严重萎缩。TGA-IgA抗体浓度与患者表现出的消化紊乱数量以及饮食不依从记录直接相关，与消化外紊乱数量呈负相关。
12至18岁的青少年是监测最少且报告肠外症状较多的群体。因此，有必要在临床实践中针对这一人群制定策略，并实施持续监测，以提高生活质量并减少可能长期出现的并发症。
