Effect of a gluten-free diet on albuminuria in children with newly diagnosed celiac disease.
Effect of a gluten-free diet on albuminuria in children with newly diagnosed celiac disease.
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DOI：
10.1159/000514635
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发表时间：
2021-04
期刊：
影响因子：
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通讯作者：
Trachtman H
中科院分区：
文献类型：
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作者：
Levine J;Hauptman L;Moy L;Trachtman H
腹腔疾病（CD）的胃肠通透性改变是由zonulin介导的。zonulin的受体在足细胞上表达。因此，我们测试了无谷蛋白饮食（GFD）对新诊断为乳糜泻的儿科患者蛋白尿的影响。我们进行了一项队列研究，比较了乳糜泻患者与对照组的尿白蛋白（μg）： Cr （mg）比（ACR）以及对GFD的反应。CD患儿（n = 46）的ACR高于对照组（n = 21），分别为20.2±5.6和8.4±1.1 μg/mg, p = 0.16，其中7/46例超过30 μg/mg（微量白蛋白尿临界值）。17例患者对GFD进行随访评估（间隔6.1±0.7个月）。基线ACR为20.7±5.2，降至10.4±1.5 μg/mg, p = 0.035。新诊断为乳糜泻的儿童和青少年有低度蛋白尿，其数值高于对照组，并在实施GFD后下降。CD可能与肾小球屏障可逆缺陷有关。
Altered gastrointestinal permeability in celiac disease (CD) is mediated by zonulin. The receptor for zonulin is expressed on podocytes. Therefore, we tested the effect of a gluten-free diet (GFD) on albuminuria in pediatric patients with newly diagnosed CD. We performed a cohort study comparing urinary albumin (μg): Cr (mg) ratio (ACR) in CD patients versus controls and in response to a GFD. Children with CD (n = 46) had higher ACR than controls (n = 21), 20.2 ± 5.6 versus 8.4 ± 1.1 μg/mg, p = 0.16 and exceeded 30 μg/mg (microalbuminuria cutoff) in 7/46 cases. Seventeen patients had a follow-up assessment (interval 6.1 ± 0.7 months) on a GFD. Baseline ACR was 20.7 ± 5.2 that fell to 10.4 ± 1.5 μg/mg, p = 0.035. Children and adolescents with newly diagnosed CD have low-grade albuminuria that is numerically higher than controls and that declined after implementation of a GFD. CD may be associated with reversible defects in the glomerular barrier.