Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy.
European Laboratory for the Investigation of Food Induced Disease (ELFID), University Federico II, 80131 Naples, Italy.
Nutrients. 2024 May 30;16(11):1708. doi: 10.3390/nu16111708.
Potential celiac disease (PCD) is a clinical condition characterised by the presence of a positive CD-specific serology and a normal intestinal architecture. Asymptomatic PCD patients are generally advised to continue on a gluten-containing diet (GCD), but long-term risks of this approach have never been explored. In the present study, we aimed to investigate nutritional and autoimmune complications possibly developing overtime in a cohort of asymptomatic PCD children on a GCD. We compared children's parameters of growth, nutritional status, and autoimmunity between the time of diagnosis and on the occasion of their last medical check, after a long-term gluten-containing diet. Altogether, we collected data from 171 PCD children with a mean follow-up time of 3 years (range 0.35-15.3 years). During follow-up, although patients did not reduce their amount of daily gluten intake, their anti-tissue transglutaminase (anti-TG2) antibodies spontaneously and significantly decreased. Most parameters analysed had not changed during follow-up (height centile, ferritin, albumin, cholesterol, calcium, alkaline phosphatase, parathormone, and vitamin D) or even improved significantly (weight and BMI centile, haemoglobin, blood iron, HDL, glycaemia, and HbA1C, < 0.05), always remaining within the limit of normality. Equally, autoantibodies for other concomitant autoimmune disorders did not increase overtime. Similar results were obtained excluding from analysis patients who had stopped producing anti-TG2 and those with a follow-up time < 3 years. Our pilot study has provided reassuring results regarding the maintenance of a gluten-containing diet in asymptomatic PCD children, even when long-term follow-up was considered.
潜在的乳糜泻（PCD）是一种临床病症，其特征在于存在阳性的 CD 特异性血清学和正常的肠道结构。无症状的 PCD 患者通常被建议继续食用含麸质饮食（GCD），但这种方法的长期风险从未被探讨过。在本研究中，我们旨在研究无症状 PCD 儿童在 GCD 下长时间可能发展的营养和自身免疫并发症。我们比较了儿童在诊断时和最后一次医疗检查时的生长、营养状况和自身免疫参数，此时他们已经长期接受含麸质饮食。总共收集了 171 名 PCD 儿童的数据，平均随访时间为 3 年（范围 0.35-15.3 年）。在随访期间，尽管患者没有减少每日的麸质摄入量，但他们的抗组织转谷氨酰胺酶（anti-TG2）抗体自发且显著下降。在随访期间，大多数分析的参数没有变化（身高百分位数、铁蛋白、白蛋白、胆固醇、钙、碱性磷酸酶、甲状旁腺素和维生素 D），甚至显著改善（体重和 BMI 百分位数、血红蛋白、血铁、HDL、血糖和 HbA1C，<0.05），始终保持在正常值范围内。同样，其他伴随自身免疫疾病的自身抗体也没有随时间增加。排除分析中停止产生 anti-TG2 的患者和随访时间<3 年的患者后，也得到了类似的结果。我们的初步研究提供了令人放心的结果，即无症状 PCD 儿童即使长期随访也可以继续食用含麸质饮食。
