Scotta M S, Salvatore S, Salvatoni A, De Amici M, Ghiringhelli D, Broggini M, Nespoli L
Pediatric Clinic University of Pavia, 2nd Faculty of Medicine and Surgery, Italy.
Am J Gastroenterol. 1997 Aug;92(8):1331-4.
The aim of the study was to establish whether body composition in patients with celiac disease is normal and influenced by the age at diagnosis or by the duration of the gluten free diet.
A group of 66 children with celiac disease and 76 healthy controls were studied by dual energy x-ray absorptiometry. We compared celiac patients with the control group, and within the celiac disease group, we compared patients with different age at diagnosis (28 diagnosed in the first 24 months vs 38 later) and with different duration of the diet (16 in gluten free diet for less than 12 months, 11 for less than 24 months, and 39 for more than 24 months).
Overall we did not find any significant difference in body composition between overall celiac patients and controls. However the fat mass, the body mass index, and the spine bone mineral density values in late diagnosed celiac patients were significantly lower than in early diagnosed patients (significance values were p < 0.009; p < 0.002; p < 0.002, respectively). Patients on diet for less than 12 months showed significantly lower bone mineral content and density than those on diet for more than 24 months (significance values were, respectively, p < 0.011 and p < 0.022). Spine mineral density was the only parameter significantly influenced both by age at diagnosis (p < 0.03) and duration of gluten free diet (p < 0.008).
Only an early diagnosis of celiac disease in pediatric age and a strict gluten free diet, lasting more than 12 months, allow celiac patients to reach a normal mineralization.
本研究旨在确定乳糜泻患者的身体成分是否正常,以及是否受诊断年龄或无麸质饮食持续时间的影响。
采用双能X线吸收法对66例乳糜泻儿童和76例健康对照者进行研究。我们将乳糜泻患者与对照组进行比较,在乳糜泻组内,我们比较了诊断年龄不同(28例在出生后前24个月诊断,38例在之后诊断)和饮食持续时间不同(16例无麸质饮食少于12个月,11例少于24个月,39例多于24个月)的患者。
总体而言,我们未发现乳糜泻患者与对照组在身体成分上有任何显著差异。然而,诊断较晚的乳糜泻患者的脂肪量、体重指数和脊柱骨矿物质密度值显著低于早期诊断的患者(显著性值分别为p < 0.009;p < 0.002;p < 0.002)。无麸质饮食少于12个月的患者的骨矿物质含量和密度显著低于饮食超过24个月的患者(显著性值分别为p < 0.011和p < 0.022)。脊柱矿物质密度是唯一受诊断年龄(p < 0.03)和无麸质饮食持续时间(p < 0.008)显著影响的参数。
只有在儿童期早期诊断乳糜泻并进行持续超过12个月的严格无麸质饮食,才能使乳糜泻患者达到正常的矿化状态。