Cardiometabolic risk factors in children with celiac disease on a gluten-free diet.
Cardiometabolic risk factors in children with celiac disease on a gluten-free diet.
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DOI：
10.5409/wjcp.v6.i3.143
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发表时间：
2017-08-08
期刊：
影响因子：
--
通讯作者：
Chiesa C
中科院分区：
文献类型：
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作者：
Anania C;Pacifico L;Olivero F;Perla FM;Chiesa C
乳糜泻（CD）是一种免疫介导的全身性疾病，由麸质和相关的脯胺引起。其特点是谷蛋白依赖临床症状、cd特异性抗体、HLA-DQ2和HLA-DQ8单倍型以及肠病的可变组合。乳糜泻唯一的治疗方法是终生无麸质饮食（GFD）。严格遵守GFD可使临床、血清学和组织学完全缓解，避免了CD患者的长期并发症。然而，这种饮食也不是没有问题。无麸质产品含有高水平的脂质、糖和盐，以改善食物的适口性和一致性，乳糜泻患者表现出过度摄入高热量和高脂血质的食物，以补偿饮食限制。因此，GFD可能对心脏代谢危险因素有负面影响，如肥胖、血脂水平、胰岛素抵抗、代谢综合征和动脉粥样硬化。在成人中，一些研究表明，GFD对心血管状况有有益的影响，而另一些研究表明，GFD有致动脉粥样硬化的作用。在儿童中，很少有关于这个问题的研究。因此，本叙述性综述的目的是分析目前关于GFD对CD患儿心脏代谢危险因素影响的临床证据。
Celiac disease (CD) is an immune-mediated systemic condition evoked by gluten and related prolamines in genetically predisposed subjects. It is characterised by a variable combination of gluten-dependent clinical symptoms, CD-specific antibodies, HLA-DQ2 and HLA-DQ8 haplotypes, and enteropathy. The only therapy of CD consists of a life-long gluten free diet (GFD). Strict GFD adherence results in full clinical, serological and histological remission, avoiding long-term complications in CD patients. However, this diet is not without problems. Gluten free products have high levels of lipids, sugar and salt to improve food palatability and consistency, and subjects with CD show an excessive consumption of hypercaloric and hyperlipidic foods to compensate dietetic restriction. GFD may therefore have a negative impact on cardiometabolic risk factors such as obesity, serum lipid levels, insulin resistance, metabolic syndrome, and atherosclerosis. In adults, some studies have suggested that GFD have a beneficial effect on cardiovascular profile, whereas others have shown an atherogenic effect of GFD. In children, very few studies are available on the issue. Thus, the aim of the present narrative review was to analyze the current clinical evidence on the impact of GFD on cardiometabolic risk factors in children with CD.