Yetişkin Çölyak Hastalarında Glutensiz Diyetin Beslenme Durumuna ve Bazı İnflamasyon Parametrelerine Etkisi

Abstract

The aim of this study is to examine the effect of gluten-free diet on nutritional status, anthropometric measurements and serum interferon-gamma (IFN-γ) and interleukin-15 (IL-15) levels in adult celiac patients and compare them with the control group and evaluate the quality of life of celiac patients. A total of 26 subjects between the 18-64 ages, who were diagnosed with celiac disease and 26 healthy volunteers as control group were included in the study. To determine the general characteristics, nutritional and physical activity status, a questionnaire was applied with face-to-face. To determine the nutritional status, a 24-hour dietary recall and food frequency questionnaire were applied, anthropometric measurements and blood samples were taken during the interview. The celiac group was trained on a gluten-free diet at the beginning and 6 weeks after the first meeting, the celiac group was questioned again, anthropometric measurements and blood samples were taken again, and the study was completed with 17 celiac patients. The average age of the celiac group was 34.8±12.9 years, and the control group was 34.5±12.4 years (p>0.05). The average age of diagnosis of celiac patients was 33.3±13.9 years, and the duration of gluten-free diet for celiac patients was 34.3±65.2 weeks. 65.4% of the celiac group have had celiac disease for less than 1 year. Initially, 41.1% of the celiac group always/often complied with the gluten-free diet, while this rate was 100.0% in the 6th week (p>0.05). In the anthropometric measurements of individuals in the celiac group, there was no change (p>0.05) compared to baseline at the 6th week, while a significant increase (p<0.05) was observed in the total quality of life scores. While no difference was observed in the nutrient intake of men in the celiac group compared to the control group, at the beginning, women in the celiac group had significantly lower intake of vitamin K, thiamine, niacin, magnesium, phosphorus and iron (p<0.05), this micronutrients intake was increased to a similar level to the control group, except thiamine, at the 6th week (p>0.05). Initially, it has been observed that individuals in the celiac group have high consumption rates of gluten-containing products such as ready-made tomato paste (94.1%), white bread, bagel (64.7%), bulgur and pasta-noodle (58.8%). In the 6th week after gluten-free diet training consumption rates of some gluten-containing products such as ready-made tomato paste (76.5%), ready-made meat products (47.1%), chocolate-wafer (23.5%) did not change (p>0.05) but the rate of those who consumed some foods such as meatballs with white bread, white bread, bagel, and doner-kebab served with pita was significantly reduced (p<0.05). Initially, serum IL-15 levels were similar in the celiac and control group (p>0.05) and IFN-γ levels were significantly higher in the celiac group (p<0.05). There was no significant difference in serum IL-15 and IFN-γ levels compared to baseline at the 6th week in the celiac group (p>0.05). Although there was a decrease in serum IL-15 and IFN-γ levels in the celiac group at the 6th week (12.8±10.2 pg/ml, 1.5±0.2 IU/mL, respectively) compared to baseline (18.1±28.4 pg/mL, 1.7±0.6 IU/mL, respectively) the difference was not significant (p>0.05). In conclusion, it has been observed that gluten-free diet training given by dietician in celiac patients has positive effects in terms of nutritional status, quality of life and gluten-free diet adherence, and the importance of gluten-free diet training in celiac patients is emphasized. But longer follow-up studies are needed to fully understand the effect of gluten-free diet on serum inflammation parameters in celiac patients.