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Prevalence of non-celiac gluten sensitivity and assessment of the response to gluten-free diet in a cohort of patients with fibromyalgia
Rheumatology ( IF 4.7 ) Pub Date : 2022-07-28 , DOI: 10.1093/rheumatology/keac434
Miriam Almirall 1, 2 , Francesc Casellas 3 , Joan Dot 4 , Inés de Torres 5, 6 , Hegoi Segurola 7 , Sara Marsal 1, 2
Affiliation  

Objectives To establish the prevalence of Non-Celiac Gluten Sensitivity (NCGS) in a cohort of Fibromyalgia patients and to evaluate their clinical response to a six-week Gluten-Free Diet (GFD), the improvement in their symptoms, the percentage of diet responders who did not fulfill the diagnostic criteria for NCGS and the baseline characteristics that were associated with diet response and diagnostic criteria fulfillment. Methods Uncontrolled prospective experimental study in a cohort of patients with Fibromyalgia from a Specialized Hospital Unit. The percentage of patients that fulfilled the Salerno Experts’ Criteria, that responded to GFD, that improved their symptomatology and baseline characteristics associated with GFD response and diagnostic criteria fulfillment were analyzed. Results 142 patients were selected and a NCGS prevalence of 5.6% was observed. 21.8% responded to GFD due to their improvement in intestinal symptoms. 74.2% of the responders did not fulfill the Salerno Experts' Criteria. The presence of diarrhea and intraepithelial lymphocytosis and lower levels of anxiety were predictive factors of GFD response. No predictive factors of NCGS criteria fulfillment were found due to the low number of discriminators between gluten and placebo. Conclusions A NCGS prevalence similar to that estimated in the general population was found. A GFD cannot be systematically recommended to all patients with Fibromyalgia, although it could be evaluated in those with diarrhea or intraepithelial lymphocytosis to evaluate if there are improvements in their intestinal symptoms.

中文翻译:

一组纤维肌痛患者非腹腔麸质敏感性的患病率和对无麸质饮食反应的评估

目的 确定一组纤维肌痛患者非腹腔麸质敏感性 (NCGS) 的患病率,并评估他们对六周无麸质饮食 (GFD) 的临床反应、症状的改善、饮食反应者的百分比谁不符合 NCGS 的诊断标准以及与饮食反应和诊断标准履行相关的基线特征。方法 对来自专科医院病房的一组纤维肌痛患者进行非对照前瞻性实验研究。分析了满足萨勒诺专家标准、对 GFD 有反应、改善了与 GFD 反应和诊断标准相关的症状学和基线特征的患者百分比。结果 142 名患者被选中,NCGS 患病率为 5。观察到 6%。由于肠道症状改善,21.8% 的人对 GFD 有反应。74.2% 的受访者不符合萨勒诺专家的标准。腹泻和上皮内淋巴细胞增多症的存在以及较低水平的焦虑是 GFD 反应的预测因素。由于麸质和安慰剂之间的鉴别因素数量较少,因此未发现 NCGS 标准满足的预测因素。结论 发现 NCGS 患病率与一般人群中的估计患病率相似。不能系统地向所有纤维肌痛患者推荐 GFD,尽管可以对腹泻或上皮内淋巴细胞增多症患者进行评估,以评估其肠道症状是否有所改善。2% 的响应者不符合萨勒诺专家的标准。腹泻和上皮内淋巴细胞增多症的存在以及较低水平的焦虑是 GFD 反应的预测因素。由于麸质和安慰剂之间的鉴别因素数量较少,因此未发现 NCGS 标准满足的预测因素。结论 发现 NCGS 患病率与一般人群中的估计患病率相似。不能系统地向所有纤维肌痛患者推荐 GFD,尽管可以对腹泻或上皮内淋巴细胞增多症患者进行评估,以评估其肠道症状是否有所改善。2% 的响应者不符合萨勒诺专家的标准。腹泻和上皮内淋巴细胞增多症的存在以及较低水平的焦虑是 GFD 反应的预测因素。由于麸质和安慰剂之间的鉴别因素数量较少,因此未发现 NCGS 标准满足的预测因素。结论 发现 NCGS 患病率与一般人群中的估计患病率相似。不能系统地向所有纤维肌痛患者推荐 GFD,尽管可以对腹泻或上皮内淋巴细胞增多症患者进行评估,以评估其肠道症状是否有所改善。由于麸质和安慰剂之间的鉴别因素数量较少,因此未发现 NCGS 标准满足的预测因素。结论 发现 NCGS 患病率与一般人群中的估计患病率相似。不能系统地向所有纤维肌痛患者推荐 GFD,尽管可以对腹泻或上皮内淋巴细胞增多症患者进行评估,以评估其肠道症状是否有所改善。由于麸质和安慰剂之间的鉴别因素数量较少,因此未发现 NCGS 标准满足的预测因素。结论 发现 NCGS 患病率与一般人群中的估计患病率相似。不能系统地向所有纤维肌痛患者推荐 GFD,尽管可以对腹泻或上皮内淋巴细胞增多症患者进行评估,以评估其肠道症状是否有所改善。
更新日期:2022-07-28
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