Scarampi Matteo, Mengoli Caterina, Miceli Emanuela, Di Stefano Michele
1st Department of Medicine, IRCCS "S.Matteo" Hospital Foundation, 27100 Pavia, Italy.
Metabolites. 2025 Jan 28;15(2):78. doi: 10.3390/metabo15020078.
Celiac disease is a chronic inflammatory condition of the small bowel caused, in genetically predisposed subjects, by the ingestion of gluten and characterised by a broad clinical polymorphism, ranging from patients with an asymptomatic or paucisymptomatic disease. The clinical presentation ranges from the presence of minor, apparently unrelated symptoms or first-degree kinship with known patients to severe intestinal malabsorption and all its clinical consequences and complications. Even if a large body of research improved our understanding of the molecular basis of celiac disease pathophysiology, enhancing the identification of new targets for future new treatments, an accurate gluten-free diet remains the mainstay of the therapy for this condition, restoring a normal absorptive mucosa. It is very rare, nowadays, to deal with patients with severe malabsorption syndrome secondary to celiac disease. Consequently, physicians are currently less prone to search for nutritional deficiencies in celiac disease. To pinpoint the possibility of both a disease-related and a diet-induced vitamin deficiency, we reviewed the literature on vitamin deficiency in this condition and reported the impact both in untreated and treated patients with celiac disease. A gluten-free diet must be tailored for each patient to meet nutritional targets: the pre-existence or diet-induced intake inadequacies should be carefully considered for an effective management of celiac disease.
乳糜泻是一种小肠慢性炎症性疾病，在具有遗传易感性的个体中，由摄入麸质引起，其临床多态性广泛，从无症状或症状轻微的患者到严重肠道吸收不良及其所有临床后果和并发症的患者都有。临床表现从轻微的、明显不相关的症状或与已知患者的一级亲属关系到严重的肠道吸收不良及其所有临床后果和并发症不等。即使大量研究增进了我们对乳糜泻病理生理学分子基础的理解，有助于确定未来新治疗方法的新靶点，但准确的无麸质饮食仍然是这种疾病治疗的主要支柱，可恢复正常的吸收性黏膜。如今，处理继发于乳糜泻的严重吸收不良综合征患者非常罕见。因此，医生目前不太倾向于在乳糜泻患者中寻找营养缺乏症。为了确定疾病相关和饮食诱导的维生素缺乏的可能性，我们回顾了关于这种情况下维生素缺乏的文献，并报告了其对未治疗和已治疗的乳糜泻患者的影响。必须为每位患者量身定制无麸质饮食以实现营养目标：在有效管理乳糜泻时，应仔细考虑先前存在的或饮食诱导的摄入不足情况。
