Nutritional status variation and intestinal and extra intestinal symptomatology in patients with celiac disease and non-celiac gluten sensitivity given specialized dietary advice

ABSTRACT Objective: To investigate the nutritional status variation and symptomatology of patients with celiac disease and non-celiac gluten sensitivity after specialized dietary advice Methods: This prospective study included 80 patients with celiac disease and non-celiac gluten sensitivity. Clinical, metabolic, and nutritional variables were collected from medical records, and the symptomatology was investigated by the Metabolic Screening Questionnaire. The variables were assessed on two occasions (T1 - before dietary advice and T2 - after dietary advice) with an interval of three months between T1 and T2 Results: The median age was 42 years. The prevalences of celiac disease and non-celiac gluten sensitivity were 66.2% and 33.8%, respectively. Normal weight prevailed at T1 (58.8%) and T2 (56.3%), but 30.0% of the patients at T1 and 34.9% of the patients at T2 had excess weight. The two conditions had similar symptomatology. The most frequent signs and symptoms on both occasions involved the gastrointestinal tract, followed by energy/activity and emotions. All symptoms decreased significantly after the introduction of a proper diet Conclusion: The patients were normal weight on both study occasions (T1 and T2), and the symptoms improved after dietary advice. Thus, we reinforce the importance of proper dietary management in both clinical conditions to make dietary adjustments that improve these individuals' symptomatology.

摘要
目的：探究乳糜泻（celiac disease）与非乳糜泻麸质敏感（non-celiac gluten sensitivity）患者接受专业膳食指导后的营养状态变化及临床症状与体征特征。
方法：本前瞻性研究共纳入80例乳糜泻及非乳糜泻麸质敏感患者。从病历中采集临床、代谢及营养相关变量，通过代谢筛查问卷（Metabolic Screening Questionnaire）评估患者的症状与体征。分别于两个时间节点（T1：膳食指导前；T2：膳食指导后，两节点间隔3个月）对上述变量进行测评。
结果：受试者中位年龄为42岁。乳糜泻与非乳糜泻麸质敏感的患病率分别为66.2%与33.8%。T1时点正常体重人群占比为58.8%，T2时点为56.3%；但T1时点有30.0%的患者存在超重，T2时点该比例达34.9%。两种疾病的症状谱与体征表现具有相似性，两次测评中最常见的体征与症状均累及胃肠道，其次为能量/活动相关表现及情绪相关症状。实施合理膳食干预后，所有症状与体征均出现显著缓解。
结论：两次研究测评时点（T1与T2）的患者均以正常体重为主，膳食指导后患者临床症状与体征得到改善。据此，我们强调针对这两类疾病开展合理膳食管理的重要性，通过膳食调整以改善患者的整体临床症状与体征。