Colaco J, Egan-Mitchell B, Stevens F M, Fottrell P F, McCarthy C F, McNicholl B
Arch Dis Child. 1987 Jul;62(7):706-8. doi: 10.1136/adc.62.7.706.
Fifty two children in whom coeliac disease was confirmed by persistent enteropathy while they were taking gluten were monitored to assess the effects of compliance with a gluten free diet (GFD). Between the ages of 17.8 and 18.5 years height (in 45 patients followed up for a mean of 14.9 years) and weight (in 43 followed up for a mean of 15.2 years) were significantly lower in those complying poorly with a GFD compared with those complying well. Of the 37 patients still attending the clinic after a mean of 25 years, having been followed up for a mean of 18.4 years, 16 who had complied well with the diet had normal or only slightly abnormal mucosal morphology whereas all 10 who had not complied had abnormal morphology. In these 10 lactase, sucrase, and alkaline phosphatase activities were significantly less than values in those who complied well. Mucosal sucrase and alkaline phosphatase activities in those who complied well were no different from those in a control population, whereas lactase activity was significantly lower. It is concluded that failure to comply with a GFD during childhood results in decreased adult stature and in persisting active enteropathy with depressed brush border enzyme activity.
52名儿童在食用麸质期间因持续性小肠病确诊为乳糜泻，对他们进行监测以评估遵循无麸质饮食（GFD）的效果。在17.8至18.5岁之间，与严格遵循GFD的儿童相比，GFD遵循情况差的儿童身高（45例患者，平均随访14.9年）和体重（43例患者，平均随访15.2年）明显更低。平均25年后仍在门诊就诊的37例患者，平均随访18.4年，其中16例严格遵循饮食的患者黏膜形态正常或仅轻度异常，而10例未遵循饮食的患者黏膜形态均异常。这10例患者的乳糖酶、蔗糖酶和碱性磷酸酶活性明显低于严格遵循饮食的患者。严格遵循饮食的患者黏膜蔗糖酶和碱性磷酸酶活性与对照人群无差异，而乳糖酶活性明显更低。结论是儿童期不遵循GFD会导致成人身高降低，并持续存在活动性小肠病且刷状缘酶活性降低。
