资讯中心

NEJM:谷蛋白摄入、HLA类型与儿童乳糜泻患病风险相关

Gluten Introduction, HLA Status, and Risk for Celiac Disease in Children
来源:PracticeUpdate 2014-10-14 09:02点击次数:535发表评论

关键信息


这项随机研究纳入了832例有一个直系亲属患乳糜泻的新生儿作为受试者,分别从6个月或12个月时添加服用谷蛋白。36周时,研究仍留有707名受试者,其中有553名为HLA标危型和高危型。在2周岁时,6个月组患自身免疫性乳糜泻的新生儿比12个月组显著增多(16% vs 7%; P = 0.002),明显乳糜泻的患儿比例也明显增多(12% vs 5%; P = 0.01)。然而,这些差异在受试者5周岁时不再显著。与标危型HLA受试者相比,高危型HLA 受试者在10周岁时患自身免疫性乳糜泻(38% vs 19%; P = 0.01)和明显乳糜泻(26% vs 16%; P =0 .05)风险较高。


作者认为,延迟摄入谷蛋白不能改变高危儿童患乳糜泻的风险,虽然它可能与延缓患病相关。


TAKE-HOME MESSAGE


This study randomly assigned 832 newborns with a first-degree relative with celiac disease to be introduced to gluten at 6 months or 12 months. At 36 months, 707 participants remained in the trial, of which 553 had standard-risk or high-risk HLA genotype. At age 2 years, significantly more children introduced to gluten at 6 months vs 12 months had celiac disease autoimmunity (16% vs 7%; P = .002) and overt celiac disease (12% vs 5%; P = .01). However, these differences did not remain significant at 5 years of age. In children with high-risk vs standard-risk HLA, the risks for celiac disease autoimmunity (38% vs 19%; P = .01) and overt celiac disease (26% vs 16%; P = .05) were higher at 10 years of age.


The authors conclude that delaying introduction of gluten does not modify the risk for celiac disease in at-risk children, although it may be associated with a delayed onset of disease.


The New England Journal of Medicine


Introduction of Gluten, HLA Status, and the Risk of Celiac Disease in Children


N. Engl. J. Med 2014 Oct 02;371(14)1295-1303, E Lionetti, S Castellaneta, R Francavilla, A Pulvirenti, E Tonutti, S Amarri, M Barbato, C Barbera, G Barera, A Bellantoni, E Castellano, G Guariso, MG Limongelli, S Pellegrino, C Polloni, C Ughi, G Zuin, A Fasano, C Catassi


This abstract is available on the publisher's site.


Access this abstract now


Copyright © 2014 Elsevier Inc. All rights reserved.


独家授权,未经许可,请勿转载。


---------------------------------------------------------------------------------------------------------------------------------------------
欢迎关注Elseviermed官方微信
学科代码: 消化病学  儿科学     关键词:谷蛋白;HLA类型;儿童乳糜泻;患病; ,新闻 爱思唯尔医学网, Elseviermed
来源: PracticeUpdate
PracticeUpdate介绍:PracticeUpdate旨在给健康领域专业人员传递与临床管理最密切的新闻和信息。基于临床医生专业领域,我们会定制化推送最新专家评议内容,并且适用于任何设备阅读。PracticeUpdate通过在线平台提供大量的宽度和深度都无以伦比的专业研究、信息和教育资源。 马上访问PracticeUpdate网站http://www.practiceupdate.com
顶一下(0
您可能感兴趣的文章
发表评论网友评论(0)
发表评论
登录后方可发表评论,点击此处登录
他们推荐了的文章