Younger age at diagnosis predisposes to mucosal recovery in celiac disease on a gluten-free diet a meta-analysis /
BACKGROUND AND AIMS: Persistent intestinal damage is associated with higher complication rates in celiac disease. We aimed to assess the potential modifiers of mucosal recovery. MATERIALS AND METHODS: We screened databases (PubMed, Embase, Cochrane Trials, and Web of Science) for papers on celiac d...
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| Dokumentumtípus: | Cikk |
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Public Library of Science (PLoS)
2017
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| Sorozat: | PLOS ONE
12 No. 11 |
| doi: | 10.1371/journal.pone.0187526 |
| mtmt: | 3287398 |
| Online Access: | http://publicatio.bibl.u-szeged.hu/12814 |
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| 024 | 7 | |a 10.1371/journal.pone.0187526 |2 doi | |
| 024 | 7 | |a 3287398 |2 mtmt | |
| 040 | |a SZTE Publicatio Repozitórium |b hun | ||
| 041 | |a zxx | ||
| 100 | 1 | |a Szakács Zsolt | |
| 245 | 1 | 0 | |a Younger age at diagnosis predisposes to mucosal recovery in celiac disease on a gluten-free diet |h [elektronikus dokumentum] : |b a meta-analysis / |c Szakács Zsolt |
| 260 | |a Public Library of Science (PLoS) |c 2017 | ||
| 300 | |a Azonosító: e0187526-Terjedelem: 24 p | ||
| 490 | 0 | |a PLOS ONE |v 12 No. 11 | |
| 520 | 3 | |a BACKGROUND AND AIMS: Persistent intestinal damage is associated with higher complication rates in celiac disease. We aimed to assess the potential modifiers of mucosal recovery. MATERIALS AND METHODS: We screened databases (PubMed, Embase, Cochrane Trials, and Web of Science) for papers on celiac disease. Papers discussing (1) celiac patients (2) follow-up biopsy and (3) mucosal recovery after commencement of a gluten-free diet were included. The primary outcome was to produce a comprehensive analysis of complete mucosal recovery (i.e., Marsh 0 on follow-up). We compared children's recovery ratios to those of adults. Patients following a strict gluten-free dietary regimen were included in a subgroup. Summary point estimates, 95% confidence intervals (CIs), and 95% predictive intervals (PIs) were calculated. Heterogeneity was tested with I2-statistic. The PROSPERO registration number is CRD42016053482. RESULTS: The overall complete mucosal recovery ratio, calculated from 37 observational studies, was 0.36 (CI: 0.28-0.44, PI: -0.12-0.84; I2: 98.4%, p<0.01). Children showed higher complete mucosal recovery ratio than adults (p<0.01): 0.65 (CI: 0.44-0.85, PI: -0.10-1.39; I2: 96.5%, p<0.01) as opposed to 0.24 (CI: 0.15-0.33, PI: -0.19-1.08; I2: 96.3%, p<0.01). In the strict dietary adherence subgroup, complete mucosal recovery ratio was 0.47 (CI: 0.24-0.70, PI: -0.47-1.41; I2: 98.8%, p<0.001). On meta-regression, diagnostic villous atrophy (Marsh 3) ratio (-8.97, p<0.01) and male ratio (+6.04, p<0.01) proved to be a significant determinant of complete mucosal recovery, unlike duration of gluten-free diet (+0.01, p = 0.62). The correlation between complete mucosal recovery ratio and age on diagnosis is of borderline significance (-0.03, p = 0.05). CONCLUSIONS: There is considerable heterogeneity across studies concerning complete mucosal recovery ratios achieved by a gluten-free diet in celiac disease. Several celiac patients fail to achieve complete mucosal recovery even if a strict dietary regimen is followed. Younger age on diagnosis, less severe initial histologic damage and male gender predispose for achieving mucosal recovery. | |
| 700 | 0 | 1 | |a Mátrai Péter |e aut |
| 700 | 0 | 1 | |a Hegyi Péter |e aut |
| 700 | 0 | 1 | |a Szabó Imre |e aut |
| 700 | 0 | 1 | |a Vincze Áron |e aut |
| 700 | 0 | 1 | |a Balaskó Márta |e aut |
| 700 | 0 | 1 | |a Mosdósi Bernadett |e aut |
| 700 | 0 | 1 | |a Sarlós Patrícia |e aut |
| 700 | 0 | 1 | |a Simon Mária |e aut |
| 700 | 0 | 1 | |a Márta Katalin |e aut |
| 700 | 0 | 1 | |a Mikó Alexandra |e aut |
| 700 | 0 | 1 | |a Pécsi Dániel |e aut |
| 700 | 0 | 1 | |a Demcsák Alexandra |e aut |
| 700 | 0 | 1 | |a Bajor Judit |e aut |
| 856 | 4 | 0 | |u http://publicatio.bibl.u-szeged.hu/12814/1/x3287398_Szakacs_Plos_u.pdf |z Dokumentum-elérés |