Evaluation of fecal gluten immunogenic peptide in a follow-up of adherence to a gluten-free diet in children with newly diagnosed celiac disease: A prospective study

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Nutrition Pub Date : 2025-05-20 DOI:10.1016/j.nut.2025.112851

Demet Teker-Düztaş M.D. , Gizem Özata-Uyar Ph.D. , Buket Dalgiç M.D.

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引用次数: 0

Abstract

Background

Celiac disease is a chronic autoimmune disorder of the small intestine for which the sole effective treatment is a lifelong gluten-free diet (GFD). Gluten immunogenic peptides (GIP) serve as biomarkers for recent gluten intake and can be utilized to assess gluten consumption levels. The aim of this study was to compare levels of fecal GIP with levels of tissue transglutaminase IgA (tTG-IgA), as well as dietary compliance, during follow-up.

Methods

This prospective, non-randomized, single-center study took place between August 2019 and August 2021 at Pediatric Gastroenterology Clinic at Gazi University Hospital in Ankara with the participation of 24 newly diagnosed celiac patients between 2 and 18 years (17 females, 7 males). Participants received GFD training from an expert dietitian, while any dietary transgressions were determined and assessed at 3 and 6 months. Levels of fecal GIP and blood tTG-IgA were analyzed at diagnosis, and again in follow-ups, using a sandwich enzyme-linked immunosorbent assay kit. Compliance with GFD was evaluated using a structured approach in terms of levels of GIP, tissue transglutaminase (tTG), Biagi score, as well as 24-hour food consumption records kept for 3 days (2 weekdays and 1 weekend).

Results

The mean age of participants was 8.3 ± 4.70 years. 23 patients (95.8%) initially had detectable GIP levels, while serum tTG-IgA was determined to be positive for all. After starting the GFD, GIP detection rates were measured as being 37.5% at 3 months, and 25% at 6 months, while tTG-IgA positivity rates were determined as being 41.7% and 37.5% respectively. While no significant correlation was found between GIP and tTG-IgA positivity. GIP detection at 3 months was moderately associated with dietitian assessments and Biagi scores (P < 0.05) but with no association at 6 months.

Conclusions

Expert dietitian training with regular monitoring increases celiac disease patients complying with GFD. Repeated fecal GIP analysis demonstrated any dietary nonadherence or unintentional gluten exposure that had occurred during the previous 2 to 7 days. It is suggested that a combination of these two tools can improve assessment of dietary compliance in celiac patients.

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评价粪便谷蛋白免疫原性肽对新诊断乳糜泻儿童坚持无谷蛋白饮食的随访：一项前瞻性研究

背景乳糜泻是一种慢性小肠自身免疫性疾病，唯一有效的治疗方法是终生无麸质饮食（GFD）。谷蛋白免疫原肽（GIP）作为近期谷蛋白摄入的生物标志物，可用于评估谷蛋白消费水平。本研究的目的是在随访期间比较粪便GIP水平与组织转谷氨酰胺酶IgA （tTG-IgA）水平以及饮食依从性。这项前瞻性、非随机、单中心研究于2019年8月至2021年8月在安卡拉Gazi大学医院儿科胃肠病学诊所进行，共有24名新诊断的乳糜泻患者，年龄在2至18岁之间（17名女性，7名男性）。参与者接受了由专家营养师提供的GFD培训，同时在3个月和6个月时确定和评估任何饮食违规行为。在诊断时分析粪便GIP和血液tTG-IgA水平，并在随访中再次使用三明治酶联免疫吸附测定试剂盒进行分析。采用结构化方法评估GFD的依从性，包括GIP水平、组织转谷氨酰胺酶（tTG）、Biagi评分以及保存3天（2个工作日和1个周末）的24小时食物消耗记录。结果患者平均年龄8.3±4.70岁。23例患者（95.8%）最初检测到GIP水平，而血清tTG-IgA被确定为所有阳性。开始GFD后，GIP在3个月时的检出率为37.5%，6个月时的检出率为25%，而tTG-IgA的检出率分别为41.7%和37.5%。而tTG-IgA阳性与GIP无显著相关性。3个月时的GIP检测与营养师评估和Biagi评分中度相关(P <；0.05)，但6个月时无相关性。结论专家营养师培训和定期监测增加了乳糜泻患者对GFD的依从性。重复的粪便GIP分析表明，在之前的2至7天内发生了任何饮食不依从或无意的麸质暴露。建议这两种工具的结合可以改善对乳糜泻患者饮食依从性的评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nutrition 医学-营养学

CiteScore

7.80

自引率

2.30%

发文量

300

审稿时长

60 days

期刊介绍： Nutrition has an open access mirror journal Nutrition: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Founded by Michael M. Meguid in the early 1980''s, Nutrition presents advances in nutrition research and science, informs its readers on new and advancing technologies and data in clinical nutrition practice, encourages the application of outcomes research and meta-analyses to problems in patient-related nutrition; and seeks to help clarify and set the research, policy and practice agenda for nutrition science to enhance human well-being in the years ahead.