Salmela Eeva, Kalle Kurppa, Lindfors Katri, Saavalainen Päivi, Huhtala Heini, Kaukinen Katri, Taavela Juha
Celiac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland.
Tampere Center for Child, Adolescent, and Maternal Health Research, Tampere University, Tampere, Finland; Department of Pediatrics, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland.
Eur J Clin Nutr. 2025 Jul 8. doi: 10.1038/s41430-025-01641-x.
Self-reported abdominal symptoms after consuming gluten-containing cereals in individuals without celiac disease (CeD) are common. The long-term outcomes of these individuals are unknown.
Seventy-six adults experiencing symptoms from gluten-containing cereals underwent exclusion of CeD and wheat allergy in 1995-1997 and were thus advised to revert to a normal gluten-containing diet. These individuals were invited to a comprehensive health examination, including measurement of CeD antibodies and symptoms and assessment of quality of life using the Gastrointestinal Symptom Rating Scale (GSRS) and Psychological General Well-Being Index (PGWB). Healthy individuals (n = 160) and untreated CeD patients (n = 128) served as controls.
Altogether, 28 individuals participated, half of whom were still avoiding gluten-containing cereals. None had acquired a diagnosis of any gastrointestinal disease, and all had negative CeD serology. The entire study group presented with significantly higher GSRS total (participants 2.8, 95% confidence interval 2.5-3.1 vs. controls 1.8, 1.7-1.9; p < 0.001) and other sub-scores than healthy controls, and higher total (vs. patients 2.5, 2.3-2.6; p = 0.041) and constipation scores than untreated CeD patients. Additionally, the group had worse PGWB total (participants 92.1, 84.9-99.4 vs. controls 105.3, 102.5-108.7; p = 0.002) and anxiety, self-control, general health, and vitality sub-cores than healthy controls, as well as self-control, general health, and vitality scores than untreated CeD patients. Twelve participants fulfilled the criteria for irritable bowel syndrome.
None of the participants had developed CeD or been diagnosed with gastrointestinal disease for 25 years. They reported more gastrointestinal symptoms and a poorer quality of life, even when compared to untreated CeD patients.
在无乳糜泻（CeD）的个体中，食用含麸质谷物后自我报告的腹部症状很常见。这些个体的长期结局尚不清楚。
1995年至1997年，76名因食用含麸质谷物而出现症状的成年人接受了乳糜泻和小麦过敏的排除检查，因此被建议恢复正常的含麸质饮食。这些个体被邀请参加全面的健康检查，包括检测乳糜泻抗体和症状，并使用胃肠道症状评分量表（GSRS）和心理总体幸福感指数（PGWB）评估生活质量。健康个体（n = 160）和未经治疗的乳糜泻患者（n = 128）作为对照。
共有28名个体参与，其中一半仍在避免食用含麸质谷物。没有人被诊断出患有任何胃肠道疾病，且所有个体的乳糜泻血清学检测均为阴性。整个研究组的GSRS总分（参与者为2.8，95%置信区间为2.5 - 3.1，而对照组为1.8，1.7 - 1.9；p < 0.001）及其他子分数均显著高于健康对照组，且总分（与患者相比为2.5，2.3 - 2.6；p = 0.041）和便秘分数高于未经治疗的乳糜泻患者。此外，该组的PGWB总分（参与者为92.1，84.9 - 99.4，而对照组为105.3，102.5 - 108.7；p = 0.002）以及焦虑、自我控制、总体健康和活力子分数均低于健康对照组，自我控制、总体健康和活力分数也低于未经治疗的乳糜泻患者。12名参与者符合肠易激综合征的标准。
25年来，没有参与者患上乳糜泻或被诊断出患有胃肠道疾病。他们报告了更多的胃肠道症状和更差的生活质量，即使与未经治疗的乳糜泻患者相比也是如此。
