Body Mass Index in Celiac Disease Beneficial Effect of a Gluten-free Diet
Body Mass Index in Celiac Disease Beneficial Effect of a Gluten-free Diet
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DOI：
10.1097/mcg.0b013e3181b7ed58
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发表时间：
2010-04-01
影响因子：
2.9
通讯作者：
Green, Peter H. R.
中科院分区：
文献类型：
--
作者：
Cheng, Jianfeng;Brar, Pardeep S.;Green, Peter H. R.
背景资料：人们担心乳糜泻患者在无麸质饮食（GFD）时超重和体重增加更多。目的：研究体重指数（BMI）以及GFD对美国乳糜泻患者BMI的影响，肥胖是一个系统性问题。方法：将诊断时和GFD 2.8年（平均）后的BMI与国家数据进行比较。结果：在我们的患者（n = 369，67.2%女性）中，17.3%体重不足，60.7%正常，15.2%超重，6.8%肥胖。所有患者均由营养师进行随访。与全国数据相比，女性BMI较低（21.9 vs. 24.2，P < 0.0001），超重人数较少（11% vs. 21%，P < 0.0001）; BMI正常的男性较多（59.5% vs. 34%，P < 0.0001），体重不足的人数较少（9.1% vs. 26.7%，P < 0.0001）。与低BMI相关的因素是女性、Marsh IIIb/c组织学和腹泻表现。在GFD，66%的体重不足的人体重增加，而54%的超重和47%的肥胖患者体重减轻。结论：GFD对BMI有有益的影响，体重不足的患者体重增加，超重/肥胖患者体重减轻。BMI的改善增加了诊断乳糜泻的动力。专家的饮食咨询可能是我们注意到的有益效果的主要因素。
Background: There is concern about celiac disease patients being overweight and gaining more weight while on a gluten-free diet (GFD).Aim: To investigate body mass index (BMI) and effect of GFD on BMI of celiac disease patients in the United States where obesity is a systematic problem.Methods: BMI at diagnosis and after 2.8 years (mean) on a GFD were compared with national data.Results: Among our patients (n = 369, 67.2% female), 17.3% were underweight, 60.7% normal, 15.2% overweight, and 6.8% obese. All patients were followed by a dietitian. Compared with national data, females had lower BMI (21.9 vs. 24.2, P < 0.0001) and fewer were overweight (11% vs. 21%, P < 0.0001); more males had a normal BMI (59.5% vs. 34%, P < 0.0001) and fewer were underweight (9.1% vs. 26.7%, P < 0.0001). Factors associated with low BMI were female sex, Marsh IIIb/c histology, and presentation with diarrhea. On GFD, 66% of those who were underweight gained weight, whereas 54% of overweight and 47% of obese patients lost weight.Conclusions: A GFD had a beneficial impact on BMI, underweight patients gained weight and overweight/obese patients lost weight. The improvement in BMI adds to the impetus to diagnose celiac disease. Expert dietary counseling may be a major factor in the beneficial effects we noted.