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无麸质饮食对患有乳糜泻和非乳糜泻麸质敏感且伴有特发性缺铁性贫血的患者的铁代谢指标有不同影响。

A gluten-free diet has a different effect on the iron profile of celiac disease and non-celiac gluten-sensitive patients with idiopathic iron deficiency anaemia.

作者信息

Haghazali Mehrdad, Rostami-Nejad Mohammad, Hajfathali Abbas, Elli Luca, Norouzinia Mohsen, Asadzadeh-Aghdaei Hamid, Sadeghi Amir, Akhavan Rahnama Mahshid, Anbarlou Azadeh, Ghasiyari Haniye, Mohaghegh-Shalmani Hamid, Rezaei-Tavirani Mostafa, Amiri Masiha, Zali Mohammad Reza

机构信息

Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

Celiac Disease and Gluten Related Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Gastroenterol Hepatol Bed Bench. 2025;18(2):211-215. doi: 10.22037/ghfbb.v18i2.3139.

Abstract

AIM

This study aimed to assess the impact of a six-week gluten-free diet (GFD) on the iron profiles of patients with non-celiac gluten sensitivity (NCGS) and CD.

BACKGROUND

Iron-deficiency anaemia (IDA) is a significant clinical feature of gluten-related disorders, especially Celiac disease (CD).

METHODS

The study included 29 CD patients (mean age 40.28 ± 15.57 years) and 29 NCGS patients (mean age 30.31 ± 7.78 years) presenting with IDA who were enrolled in the study during 2023-2024. Haemoglobin, serum iron, serum ferritin, total iron-binding capacity (TIBC), and transferrin saturation (TSAT) levels were assessed at the beginning and after six weeks of GFD. HLA typing was conducted using the Real-time PCR-based SYBR Green method.

RESULTS

Ferritin levels significantly increased in both CD and NCGS groups after the GFD, from 43.7807 to 50.5279 ng/mL and 23.0862 to 42.9910 ng/mL, respectively. Moreover, serum iron and TSAT levels significantly increased in the NCGS group, from 64.8034 to 81.3466 μg/dL and 19.29 ± 11.70 to 23.99 ± 9.05, respectively (p = 0.003).

CONCLUSION

The most frequent symptoms in CD and NCGS patients were bloating/bone disease (62.1%) and bone disease (37.9%), respectively. GFD was effective in improving IDA in both CD and NCGS patients. Further research is necessary to assess the therapeutic effect of GFD in patients with gastrointestinal symptoms and IDA.

摘要

目的

本研究旨在评估为期六周的无麸质饮食(GFD)对非乳糜泻性麸质敏感(NCGS)患者和乳糜泻(CD)患者铁代谢指标的影响。

背景

缺铁性贫血(IDA)是麸质相关疾病的一个重要临床特征,尤其是乳糜泻(CD)。

方法

本研究纳入了29例CD患者(平均年龄40.28±15.57岁)和29例NCGS患者(平均年龄30.31±7.78岁),这些患者均患有IDA,于2023年至2024年期间入组研究。在开始GFD饮食前及六周后评估血红蛋白、血清铁、血清铁蛋白、总铁结合力(TIBC)和转铁蛋白饱和度(TSAT)水平。采用基于实时PCR的SYBR Green方法进行HLA分型。

结果

GFD饮食后,CD组和NCGS组的铁蛋白水平均显著升高,分别从43.7807 ng/mL升至50.5279 ng/mL和从23.0862 ng/mL升至42.9910 ng/mL。此外,NCGS组的血清铁和TSAT水平显著升高,分别从64.8034 μg/dL升至81.3466 μg/dL以及从19.29±11.70升至23.99±9.05(p = 0.003)。

结论

CD患者和NCGS患者最常见的症状分别是腹胀/骨骼疾病(62.1%)和骨骼疾病(37.9%)。GFD饮食对改善CD患者和NCGS患者的IDA均有效。有必要进一步研究评估GFD饮食对有胃肠道症状和IDA患者的治疗效果。

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本文引用的文献

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AGA Clinical Practice Update on Management of Iron Deficiency Anemia: Expert Review.AGA 临床实践更新:缺铁性贫血管理:专家综述。
Clin Gastroenterol Hepatol. 2024 Aug;22(8):1575-1583. doi: 10.1016/j.cgh.2024.03.046. Epub 2024 Jun 12.
2
Updates in the diagnosis and management of coeliac disease.乳糜泻的诊断和治疗进展。
Best Pract Res Clin Gastroenterol. 2023 Jun-Aug;64-65:101843. doi: 10.1016/j.bpg.2023.101843. Epub 2023 Jul 4.
4
Iron Deficiency Anemia in Celiac Disease.乳糜泻相关缺铁性贫血。
Nutrients. 2021 May 17;13(5):1695. doi: 10.3390/nu13051695.

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