A Randomized Trial Comparing the Specific Carbohydrate Diet to a Mediterranean Diet in Adults With Crohn's Disease.
A Randomized Trial Comparing the Specific Carbohydrate Diet to a Mediterranean Diet in Adults With Crohn's Disease.
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一项对成人克罗恩病患者的特定碳水化合物饮食和地中海饮食进行比较的随机试验
DOI：
10.1053/j.gastro.2021.05.047
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发表时间：
2021-09
期刊：
影响因子：
29.4
通讯作者：
DINE-CD Study Group
中科院分区：
文献类型：
--
作者：
Lewis JD;Sandler RS;Brotherton C;Brensinger C;Li H;Kappelman MD;Daniel SG;Bittinger K;Albenberg L;Valentine JF;Hanson JS;Suskind DL;Meyer A;Compher CW;Bewtra M;Saxena A;Dobes A;Cohen BL;Flynn AD;Fischer M;Saha S;Swaminath A;Yacyshyn B;Scherl E;Horst S;Curtis JR;Braly K;Nessel L;McCauley M;McKeever L;Herfarth H;DINE-CD Study Group
本研究比较了特定碳水化合物饮食（SCD）与地中海饮食（MD）治疗轻度至中度克罗恩病（CD）的有效性。患有CD和轻中度症状的成年患者以1：1的比例随机分配，服用MD或SCD 12周。在前6周，参与者根据他们指定的饮食接受准备好的膳食和零食。6周后，参与者被指示独立地遵循饮食。主要结局为第6周时症状缓解。第6周的关键次要结局包括：粪便钙卫蛋白（FC）反应（FC <250 μg/g，基线FC >250 μg/g的患者降低>50%）和C反应蛋白（CRP）反应（高敏CRP（hsCRP）<5 mg/L，hsCRP > 5 mg/L的患者较基线降低>50%）。194例患者接受随机化，191例纳入疗效分析。SCD组在第6周达到症状缓解的受试者百分比并不上级SCD组（SCD 46.5%，MD 43.5%; P = 0.77）。8/23例SCD受试者（34.8%）和4/13例MD受试者（30.8%）实现了FC缓解（P = 0.83）。2/37例SCD受试者（5.4%）和1/28例MD受试者（3.6%）实现了CRP应答（P = 0.68）。SCD在实现症状缓解、FC应答和CRP应答方面并不优于MD上级。CRP反应不常见。鉴于这些结果，更容易遵循MD，以及与MD相关的其他健康益处，对于大多数具有轻度至中度症状的CD患者，MD可能优于SCD。 NCT 03058679在这项针对轻度至中度症状克罗恩病患者的随机对照试验中，特定碳水化合物饮食在实现症状缓解方面并不上级地中海饮食。
This study compared the effectiveness of the Specific Carbohydrate Diet (SCD) to the Mediterranean Diet (MD) as treatment for Crohn’s disease (CD) with mild to moderate symptoms. Adult patients with CD and with mild-moderate symptoms were randomly assigned 1:1 to consume the MD or SCD for 12 weeks. For the first 6-weeks, participants received prepared meals and snacks according to their assigned diet. After 6-weeks, participants were instructed to follow the diet independently. The primary outcome was symptomatic remission at week 6. Key secondary outcomes at week 6 included: fecal calprotectin (FC) response (FC <250 μg/g and reduction by >50% among those with baseline FC >250 μg/g) and C-Reactive Protein (CRP) response (high-sensitivity CRP (hsCRP) <5 mg/L and >50% reduction from baseline among those with hsCRP >5mg/L). 194 patients were randomized, and 191 were included in the efficacy analyses. The percentage of participants who achieved symptomatic remission at week 6 was not superior with SCD (SCD 46.5%, MD 43.5%; P = .77). FC response was achieved in 8/23 participants (34.8%) with SCD and 4/13 participants (30.8%) with MD (P = .83). CRP response was achieved in 2/37 participants (5.4%) with SCD and 1/28 participant (3.6%) with MD (P = .68). SCD was not superior to MD to achieve symptomatic remission, FC response and CRP response. CRP response was uncommon. Given these results, the greater ease of following the MD, and other health benefits associated with MD, the MD may be preferred to the SCD for most patients with CD with mild to moderate symptoms. NCT03058679 In this randomized controlled trial of patients with Crohn’s disease and mild to moderate symptoms, the Specific Carbohydrate Diet was not superior to a Mediterranean Diet to achieve symptomatic remission.
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影响因子：
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作者：
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通讯作者：
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