Randomized controlled trial of a gluten-free diet in patients with schizophrenia positive for antigliadin antibodies (AGA IgG): a pilot feasibility study
Randomized controlled trial of a gluten-free diet in patients with schizophrenia positive for antigliadin antibodies (AGA IgG): a pilot feasibility study
复制标题
DOI：
10.1503/jpn.180174
复制
发表时间：
2019-07-01
影响因子：
4.3
通讯作者：
Eaton, William W.
中科院分区：
文献类型：
--
作者：
Kelly, Deanna L.;Demyanovich, Haley K.;Eaton, William W.
背景 大约三分之一的精神分裂症患者的免疫球蛋白 G 型抗麦胶蛋白抗体 (AGA IgG) 水平升高，这一比例高于健康对照者。我们对 AGA IgG 呈阳性的精神分裂症患者进行了首次无麸质饮食与含麸质饮食的双盲临床试验。方法 在这项试点可行性研究中，16 名患有精神分裂症或分裂情感障碍且 AGA IgG 升高（>= 20 U）但乳糜泻呈阴性的参与者被送往住院病房进行为期 5 周的试验。所有参与者都接受标准化的无麸质膳食，并以双盲方式随机接受每天含有 10 克麸质面粉或 10 克米粉的奶昔。在基线和终点时对参与者的精神、认知和胃肠道症状进行评估。结果 16 名参与者中，14 人完成了为期 5 周的试验（2 人因行政原因提前终止）。与接受含麸质饮食的参与者相比，接受无麸质饮食的参与者在临床总体印象量表（Cohen d = -0.75）和阴性症状（Cohen d = -0.53）上表现出改善。我们注意到积极或整体认知症状没有改善，但确实观察到无麸质饮食的注意力有所改善（Cohen d = 0.60）。与含麸质组相比，无麸质组的胃肠道不良反应得到了显着改善。各组之间的不良反应相似。局限性 本研究因样本量较小而受到限制；需要进行更大规模的研究。结论 这项可行性研究表明，从饮食中去除麸质与精神分裂症或分裂情感障碍患者的精神和胃肠道症状的改善有关。
Background Approximately one-third of people with schizophrenia have elevated levels of antigliadin antibodies of the immunoglobulin G type (AGA IgG) - a higher rate than seen in healthy controls. We performed the first double-blind clinical trial of gluten-free versus gluten-containing diets in a subset of patients with schizophrenia who were positive for AGA IgG. Methods In this pilot feasibility study, 16 participants with schizophrenia or schizoaffective disorder who had elevated AGA IgG (>= 20 U) but were negative for celiac disease were admitted to an inpatient unit for a 5-week trial. All participants received standardized gluten-free meals and were randomized in a double-blind fashion to receive a shake containing 10 g of gluten flour or 10 g of rice flour each day. Participants were rated for psychiatric, cognitive and gastrointestinal symptoms at baseline and end point. Results Of the 16 participants, 14 completed the 5-week trial (2 discontinued early for administrative reasons). Compared with participants on the gluten-containing diet, participants on the gluten-free diet showed improvement on the Clinical Global Impressions scale (Cohen d = -0.75) and in negative symptoms (Cohen d = -0.53). We noted no improvement in positive or global cognitive symptoms, but did observe an improvement in attention favouring the gluten-free diet (Cohen d = 0.60). Robust improvements in gastrointestinal adverse effects occurred in the gluten-free group relative to the gluten-containing group. Adverse effects were similar between groups. Limitations This study was limited by its small sample size; larger studies are needed. Conclusion This feasibility study suggests that removal of gluten from the diet is associated with improvement in psychiatric and gastrointestinal symptoms in people with schizophrenia or schizoaffective disorder.