无麸质饮食对乳糜泻诊断后第一年1型糖尿病儿童和青少年代谢控制和生长参数的影响:一项回顾性病例-对照研究

IF 5.6 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Pediatric Diabetes Pub Date : 2025-07-04 eCollection Date: 2025-01-01 DOI:10.1155/pedi/1283259
Ahmed Monir Hegab, Ashraf Abou-Taleb
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引用次数: 0

摘要

目的:评估乳糜泻和无谷蛋白饮食(GFD)与1型糖尿病(T1DM)儿童和青少年乳糜泻诊断后第一年代谢控制和生长参数的关系。方法:这是一项回顾性病例对照研究,包括47名患有T1DM的儿童和青少年。结果:与匹配的对照组相比,患有乳糜泻的儿童和青少年在诊断时胰岛素剂量显著降低(p=0.002)。两组在诊断乳糜泻时或1年后的HbA1c水平无显著差异(p分别=0.27和0.81)。乳糜泻患者在诊断时和1年后的体重、身高和体重指数(BMI)标准偏差评分(SDSs)均显著降低。两组在诊断时或1年后的空腹血脂水平无显著差异。诊断时绒毛萎缩的患者1年后HbA1c水平显著升高(p=0.04)。即使乳糜泻自身抗体正常的患者,1年后体重、身高和BMI SDS也没有显著改善。结论:患有T1DM的儿童和青少年在乳糜泻诊断时胰岛素需求和生长参数较低。诊断性小肠活检的绒毛萎缩与1年后血糖控制恶化有关。需要更长的随访时间才能发现生长参数的显著改善。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of Gluten-Free Diet on Metabolic Control and Growth Parameters Among Children and Adolescents With Type 1 Diabetes During the First Year After Diagnosis of Celiac Disease: A Retrospective Case-Control Study.

Aims: Assessment of celiac disease and gluten-free diet (GFD) associations with metabolic control and growth parameters in children and adolescents with type 1 diabetes mellitus (T1DM) during the first year after diagnosis of celiac disease. Methods: This was a retrospective case-control study that included 47 children and adolescents with T1DM aged <18 years who attended the pediatric diabetes clinic at Sohag University Hospital, Egypt, and had a biopsy-proven diagnosis of celiac disease between January 2017 and December 2021. Each case had two age-, sex-, and duration of diabetes-matched control participants with T1DM who had persistently negative celiac screening tests. Clinical characteristics, growth parameters, insulin doses, celiac autoantibody titers, and HbA1c levels throughout the first year after diagnosis of celiac disease were obtained from the medical records. Results: Children and adolescents with celiac disease had significantly lower insulin doses at diagnosis (p=0.002) compared to their matched controls. There were no significant differences between both groups regarding the HbA1c levels at diagnosis of celiac disease or after 1 year (p=0.27 and 0.81, respectively). Patients with celiac disease had significantly lower weight, height, and body mass index (BMI) standard deviation scores (SDSs) at diagnosis and after 1 year. There were no significant differences between both groups regarding the fasting lipid profiles at diagnosis or after 1 year. Patients with villous atrophy at diagnosis had significantly higher HbA1c levels after 1 year (p=0.04). There were no significant improvements in weight, height, and BMI SDS after 1 year even in patients with normalized celiac autoantibodies. Conclusions: Children and adolescents with T1DM had lower insulin requirements and growth parameters at diagnosis of celiac disease. Villous atrophy at diagnostic small bowel biopsies was associated with worsening glycemic control after 1 year. Longer follow-up periods are required to detect significant improvements in growth parameters.

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来源期刊
Pediatric Diabetes
Pediatric Diabetes 医学-内分泌学与代谢
CiteScore
6.60
自引率
14.70%
发文量
141
审稿时长
4-8 weeks
期刊介绍: Pediatric Diabetes is a bi-monthly journal devoted to disseminating new knowledge relating to the epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes in childhood and adolescence. The aim of the journal is to become the leading vehicle for international dissemination of research and practice relating to diabetes in youth. Papers are considered for publication based on the rigor of scientific approach, novelty, and importance for understanding mechanisms involved in the epidemiology and etiology of this disease, especially its molecular, biochemical and physiological aspects. Work relating to the clinical presentation, course, management and outcome of diabetes, including its physical and emotional sequelae, is considered. In vitro studies using animal or human tissues, whole animal and clinical studies in humans are also considered. The journal reviews full-length papers, preliminary communications with important new information, clinical reports, and reviews of major topics. Invited editorials, commentaries, and perspectives are a regular feature. The editors, based in the USA, Europe, and Australasia, maintain regular communications to assure rapid turnaround time of submitted manuscripts.
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