Cardiovascular disease risk factor profiles in children with celiac disease on gluten-free diets
Cardiovascular disease risk factor profiles in children with celiac disease on gluten-free diets
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DOI：
10.3748/wjg.v19.i34.5658
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发表时间：
2013-09-14
影响因子：
4.3
通讯作者：
Giovannini, Marcello
中科院分区：
文献类型：
--
作者：
Norsa, Lorenzo;Shamir, Raanan;Giovannini, Marcello
目的：描述无麸质饮食（GFD）的乳糜泻（CD）儿童人群中心血管疾病（CVD）的危险因素：这项横断面多中心研究在以色列施耐德儿童医学中心（Petach Tiqva，以色列）和圣保罗医院（米兰，意大利）进行。我们招募了114名血清学缓解的CD儿童，他们接受GFD至少一年。在入组时，对人体测量、血脂和血糖进行评估，并与诊断时的值进行比较。稳态模型评估估计的胰岛素抵抗被计算作为衡量insulinresistance.Results：三个或更多的伴随CVD危险因素[体重指数，腰围，低密度脂蛋白（LDL）胆固醇，甘油三酯，血压和胰岛素抵抗]确定在14%的CD受试者的GFD。最常见的CVD风险因素是空腹甘油三酯高（34.8%）、血压升高（29.4%）和计算的LDL胆固醇浓度高（24.1%）。在GFD中，4名儿童（3.5%）有胰岛素抵抗。意大利队列的空腹胰岛素和HOMA-IR显著高于以色列队列（P < 0.001）。与诊断时的值（10%）相比，GFD儿童的临界LDL胆固醇患病率（24%）增加（P = 0.090）。超重（从8.8%到11.5%）和肥胖（从5.3%到8.8%）增加的趋势被认为是对GFD.CONCLUSION：这份报告的胰岛素抵抗和心血管疾病的危险因素在乳糜泻儿童突出的重要性，心血管疾病筛查，需要针对心血管疾病预防的饮食咨询。(C)2013年百世登。All rights reserved.
AIM: To describe the cardiovascular disease (CVD) risk factors in a population of children with celiac disease (CD) on a gluten-free diet (GFD).METHODS: This cross-sectional multicenter study was performed at Schneider Children's Medical Center of Israel (Petach Tiqva, Israel), and San Paolo Hospital (Milan, Italy). We enrolled 114 CD children in serologic remission, who were on a GFD for at least one year. At enrollment, anthropometric measurements, blood lipids and glucose were assessed, and compared to values at diagnosis. The homeostasis model assessment-estimated insulin resistance was calculated as a measure of insulin resistance.RESULTS: Three or more concomitant CVD risk factors [body mass index, waist circumference, low density lipoprotein (LDL) cholesterol, triglycerides, blood pressure and insulin resistance] were identified in 14% of CD subjects on a GFD. The most common CVD risk factors were high fasting triglycerides (34.8%), elevated blood pressure (29.4%), and high concentrations of calculated LDL cholesterol (24.1%). On a GFD, four children (3.5%) had insulin resistance. Fasting insulin and HOMA-IR were significantly higher in the Italian cohort compared to the Israeli cohort (P < 0.001). Children on a GFD had an increased prevalence of borderline LDL cholesterol (24%) when compared to values (10%) at diagnosis (P = 0.090). Trends towards increases in overweight (from 8.8% to 11.5%) and obesity (from 5.3% to 8.8%) were seen on a GFD.CONCLUSION: This report of insulin resistance and CVD risk factors in celiac children highlights the importance of CVD screening, and the need for dietary counseling targeting CVD prevention. (C) 2013 Baishideng. All rights reserved.