Metabolic effects in patients with celiac disease, patients with nonceliac gluten sensitivity, and asymptomatic controls, after six months of a gluten-free diet

• Published in: Revista de Gastroenterología de México (English Edition) 2020-04, Vol.85 (2), p.109-117
• Main Authors: Remes-Troche, J.M., Cobos-Quevedo, O. De J., Rivera-Gutiérrez, X., Hernández, G., de la Cruz-Patiño, E., Uscanga-Domínquez, L.F.
• Format: Article
• Language: English
• Subjects: Celiac disease; Enfermedad celíaca; Gluten; Metabolic syndrome; Obesidad; Obesity; Sensibilidad; Sensitivity; Síndrome metabólico
• ISSN: 2255-534X; 2255-534X
• DOI: 10.1016/j.rgmxen.2019.02.011

It is essential for patients with celiac disease (CD) to be on a gluten-free diet (GFD) but said diet has also been reported to increase the risk for metabolic syndrome. There is no evidence on the metabolic effects of a GFD in patients with nonceliac gluten sensitivity (NCGS) or in asymptomatic subjects. Therefore, the aim of the present study was to evaluate the metabolic effects of a GFD over a 6-month period in patients with CD, patients with NCGS, and in asymptomatic controls (ACs). A prospective study was conducted that evaluated metabolic syndrome and its components of obesity, high blood pressure, hepatic steatosis, and hyperglycemia at the baseline and at 6 months. A total of 66 subjects (22 CD, 22 NCGS, and 22 AC) were included in the study. At the baseline, 10% of the patients with CD presented with obesity, high blood pressure, hepatic steatosis, and metabolic syndrome. After 6 months, obesity and metabolic syndrome increased by 20% (p=0.125). In the patients with NCGS, obesity increased by 5% after the GFD and 20% of those patients presented with de novo hepatic steatosis. The prevalence of obesity decreased by 10% in the controls after the GFD (30 vs 20%, p=0.5) and none of the other components of metabolic syndrome were affected. The metabolic benefits and risks of a GFD should be considered when prescribing said diet in the different populations that opt for that type of intervention. La dieta libre de gluten (DLG) es indispensable para los pacientes con enfermedad celíaca (EC). Sin embargo, también se ha descrito que esta dieta aumenta el riesgo de síndrome metabólico (SM). La evidencia respecto a los efectos metabólicos de una DLG en pacientes con sensibilidad al gluten no celíaca (SGNC) y en sujetos asintomáticos se desconoce. El objetivo de este estudio fue evaluar los efectos metabólicos de una DLG durante 6 meses en pacientes con EC, SGNC y controles asintomáticos. Se realizó un estudio prospectivo en donde de forma basal y a los 6 meses se evaluaron los componentes del SM como obesidad, esteatosis hepática, hiperglucemia e hipertensión arterial. Se incluyeron un total de 66 sujetos (22 EC, 22 SGNC y 22 controles asintomáticos). De forma basal el 10% de los pacientes con EC tuvo obesidad, SM, hipertensión y esteatosis hepática. Después de 6 meses el 20% de los pacientes desarrolló SM y obesidad (p=0.125). En los pacientes con SGNC la obesidad después de la DLG aumentó en un 5%, mientras que el 20% tuvo esteatosis hepática de novo. En