Many Ittai, Amir Achiya, Ben-Tov Amir, Lev Hadar Moran, Anafy Adi, Cohen Shlomi, Yerushalmy-Feler Anat
Pediatric Gastroenterology Institute, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
The Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
Acta Paediatr. 2025 Sep;114(9):2373-2381. doi: 10.1111/apa.70124. Epub 2025 May 7.
The adherence to a gluten-free diet (GFD) in celiac disease (CD) is influenced by socioeconomic factors and language barriers, which are especially relevant to minority populations. The study aimed to compare CD outcomes in children of Eritrean asylum seekers living in Israel to those of native Israeli children.
This retrospective case-control study included demographic, clinical, laboratory, endoscopic, and histologic data of all Eritrean children diagnosed with CD during 2015-2023. For each Eritrean child, 5 consecutive Israeli children served as controls.
The study included 22 Eritrean children and 110 controls. Over a 12-month follow-up under a GFD, more Eritrean children maintained anti-tissue transglutaminase (TTG) antibodies > 10 times above the ULN compared to controls (43% vs. 1.4%, p < 0.001). A multivariate analysis indicated a greater likelihood of achieving normalisation of anti-TTG antibodies in the controls (hazard ratio = 4.97, 95% confidence interval 1.17-21.13, p = 0.030). Complete compliance to a GFD was reported by 7 (50%) Eritrean children versus 69 (99%) controls (p < 0.001).
Eritrean asylum seekers' children with CD have a significantly slower decline in anti-TTG antibody levels compared to native Israeli children. Intervention to improve adherence to a GFD may positively impact CD outcomes in this population.
乳糜泻（CD）患者对无麸质饮食（GFD）的依从性受社会经济因素和语言障碍影响，这些因素对少数族裔群体尤为重要。本研究旨在比较生活在以色列的厄立特里亚寻求庇护儿童与以色列本土儿童的CD治疗结果。
这项回顾性病例对照研究纳入了2015年至2023年期间所有被诊断为CD的厄立特里亚儿童的人口统计学、临床、实验室、内镜和组织学数据。对于每一名厄立特里亚儿童，选取5名连续的以色列儿童作为对照。
该研究纳入了22名厄立特里亚儿童和110名对照。在GFD下进行12个月的随访后，与对照组相比，更多的厄立特里亚儿童抗组织转谷氨酰胺酶（TTG）抗体维持在高于ULN的10倍以上（43%对1.4%，p<0.001）。多变量分析表明，对照组抗TTG抗体实现正常化的可能性更大（风险比=4.97，95%置信区间1.17-21.13，p=0.030）。7名（50%）厄立特里亚儿童报告完全依从GFD，而对照组为69名（99%）（p<0.001）。
与以色列本土儿童相比，患有CD的厄立特里亚寻求庇护儿童的抗TTG抗体水平下降明显更慢。改善对GFD依从性的干预措施可能会对该人群的CD治疗结果产生积极影响。
