Background and study aims:Published follow-up data on small-intestinal recovery in patients with celiac disease are scarce and contradictory.This is especially the case for adult patients,who often show incomplete his...Background and study aims:Published follow-up data on small-intestinal recovery in patients with celiac disease are scarce and contradictory.This is especially the case for adult patients,who often show incomplete histological recovery after starting a gluten-free diet(GFD) .We conducted a 2-year prospective study to evaluate the effectiveness of a GFD in improving the endoscopic and histological duodenal findings in adults with celiac disease.Patients and methods:We studied 42 consecutive adults with newly diagnosed celiac disease(13 men,29 women;mean age 32.7 years,range 15-72 years) .All the patients underwent esophagogastroduodenoscopy and small-bowel biopsy.We devised our own grading system for the endoscopic appearance of the duodenum,which ranged from “ normal” appearance to “ mild”,“ moderate”,or “ severe” alterations.Small-bowel biopsies were obtained from the second part of the duodenum(and from the duodenal bulb when it had a micronodular appearance) .The histopathological appearances were described according to modified Marsh criteria.Results:Anormal endoscopic appearance in the duodenum was found in 5/42 patients(11.9%) at entry and in 32/42 patients(76.2%) after 2 years on a GFD.Subdividing the patients according to age,patients aged from 15 years to 60 years showed significant improvement within 12 months(P< 0.0001 for patients aged from 15 years to 45 years;P< 0.003 for patients in the 46 years to 60 years group) ,whereas the improvement in endoscopic findings in patients older than 60 years was not statistically significant,even 24 months after starting the GFD.“ Normal” histology was reported in none of the patients at entry,but in 25 patients(59.5 %) after 24 months on a GFD,but this parameter did not show a significant improvement until the patients had been on the GFD for 12 months(P < 0.0001) .Only the younger patients(5-30 years) showed significant improvement of histology within 12 months(P< 0.034) ;older patients(>30 years) showed histological improvement but this was not statistically significant,even after 24 months on a GFD.Conclusions:This study shows for the first time that endoscopic recovery is faster than histological recovery in adults with celiac disease who go on a GFD.Moreover,older patients showed incomplete endoscopic and histological recovery even 24 months after starting a GFD.We therefore advise,as a minimum recommendation,that follow-up biopsies should be taken 1-2 years after starting a GFD in adults with celiac disease.展开更多
目的横断面研究不同性别的糖尿病患者多种饮食模式对全因死亡的影响和差异。方法分析来自美国国家健康和营养检查调查(National Health and Nutrition Examination Survey,NHANES)数据库中20002名参与者(3737名糖尿病患者)。用COX比例...目的横断面研究不同性别的糖尿病患者多种饮食模式对全因死亡的影响和差异。方法分析来自美国国家健康和营养检查调查(National Health and Nutrition Examination Survey,NHANES)数据库中20002名参与者(3737名糖尿病患者)。用COX比例风险回归模型分析饮食质量评分与不同性别糖尿病患者全因死亡的关系。分层分析评估其他因素是否与饮食模式评分有相互作用。结果在74个月的中位随访期内,有512例死亡记录,男性311例,女性201例。饮食评分较高的糖尿病患者组对比较低组调整风险比如下:饮食炎症指数[男性:风险比(hazard ratio,HR)=1.22,P=0.084;女性HR=1.00,P=0.818];地中海饮食评分(男性:HR=0.99,P=0.873;女性HR=0.79,P=0.027);健康饮食指数-2020(男性HR=1.00,P=0.956;女性HR=0.83,P=0.046)。饮食评分对糖尿病患者死亡风险的影响是独立的,未发现饮食评分与其他变量存在内在的相互作用。结论糖尿病人群中,地中海饮食和健康饮食指数-2020与女性较低的死亡风险相关,而在男性未发现明显的关联。展开更多
目的:研究“互联网+”模式对3~6岁儿童肥胖相关饮食行为的干预效果。方法:采用整群随机抽样方法抽取南充市顺庆区4所条件基本相同的幼儿园中2018年6~12月在南充市中心医院儿童保健门诊就诊的3~6岁单纯性肥胖儿童96例,随机分为试验组46例...目的:研究“互联网+”模式对3~6岁儿童肥胖相关饮食行为的干预效果。方法:采用整群随机抽样方法抽取南充市顺庆区4所条件基本相同的幼儿园中2018年6~12月在南充市中心医院儿童保健门诊就诊的3~6岁单纯性肥胖儿童96例,随机分为试验组46例,对照组50例,试验组进行常规儿童保健+饮食行为干预+“互联网+”干预+个案管理,对照组进行常规儿童保健+饮食行为干预,1年后观察两组儿童干预效果,包括身高、体质量、腰围、体质量指数(body mass index,BMI)、体脂百分比等。结果:干预前两组儿童身高、体质量、腰围、体质指数、体脂百分比比较差异无统计学意义(P>0.05),干预后两组儿童各指标均明显改善(P<0.05),试验组改善更明显(P<0.01)。结论“:互联网+”模式下3~6岁儿童肥胖相关饮食行为干预相比传统线下干预模式效更显著,可以更好达到预防、干预、控制肥胖的目的。展开更多
目的:基于CiteSpace和VOSviewer可视化软件对饮食限制(DR)调控炎症文献进行定量可视化分析,探索DR调控炎症领域的研究热点和趋势。方法:检索2010年1月1日至2022年9月29日Web of Science核心数据库中收录的DR调控炎症相关文献共1678篇,...目的:基于CiteSpace和VOSviewer可视化软件对饮食限制(DR)调控炎症文献进行定量可视化分析,探索DR调控炎症领域的研究热点和趋势。方法:检索2010年1月1日至2022年9月29日Web of Science核心数据库中收录的DR调控炎症相关文献共1678篇,经筛查最终获得1344篇,使用CiteSpace和VOSviewer可视化软件对检索到的文献数据进行年发文量、国家、机构、作者、被引频次和关键词的定量和可视化分析。结果:最终获得的1344篇文献年发文量总体呈上升趋势,文献最高被引频次为1676次,美国(481篇)是出产文献数量最多的国家,中国(181篇)位居第二。DR调控炎症领域研究热点集中在热量限制(CR)、生酮饮食、衰老、代谢性疾病、脂肪组织及肠道菌群等方面。结论:DR调控炎症愈来愈受到国际和国内研究者青睐,未来研究热点可能是CR模拟物(CRM)、肠道菌群、神经退行性疾病和心血管疾病,总体研究趋势为进一步明确DR的抗炎机制,寻找新的治疗靶点,将更多经过体外和动物模型证实的有效方案进行更严格的临床试验。展开更多
文摘Background and study aims:Published follow-up data on small-intestinal recovery in patients with celiac disease are scarce and contradictory.This is especially the case for adult patients,who often show incomplete histological recovery after starting a gluten-free diet(GFD) .We conducted a 2-year prospective study to evaluate the effectiveness of a GFD in improving the endoscopic and histological duodenal findings in adults with celiac disease.Patients and methods:We studied 42 consecutive adults with newly diagnosed celiac disease(13 men,29 women;mean age 32.7 years,range 15-72 years) .All the patients underwent esophagogastroduodenoscopy and small-bowel biopsy.We devised our own grading system for the endoscopic appearance of the duodenum,which ranged from “ normal” appearance to “ mild”,“ moderate”,or “ severe” alterations.Small-bowel biopsies were obtained from the second part of the duodenum(and from the duodenal bulb when it had a micronodular appearance) .The histopathological appearances were described according to modified Marsh criteria.Results:Anormal endoscopic appearance in the duodenum was found in 5/42 patients(11.9%) at entry and in 32/42 patients(76.2%) after 2 years on a GFD.Subdividing the patients according to age,patients aged from 15 years to 60 years showed significant improvement within 12 months(P< 0.0001 for patients aged from 15 years to 45 years;P< 0.003 for patients in the 46 years to 60 years group) ,whereas the improvement in endoscopic findings in patients older than 60 years was not statistically significant,even 24 months after starting the GFD.“ Normal” histology was reported in none of the patients at entry,but in 25 patients(59.5 %) after 24 months on a GFD,but this parameter did not show a significant improvement until the patients had been on the GFD for 12 months(P < 0.0001) .Only the younger patients(5-30 years) showed significant improvement of histology within 12 months(P< 0.034) ;older patients(>30 years) showed histological improvement but this was not statistically significant,even after 24 months on a GFD.Conclusions:This study shows for the first time that endoscopic recovery is faster than histological recovery in adults with celiac disease who go on a GFD.Moreover,older patients showed incomplete endoscopic and histological recovery even 24 months after starting a GFD.We therefore advise,as a minimum recommendation,that follow-up biopsies should be taken 1-2 years after starting a GFD in adults with celiac disease.
文摘目的横断面研究不同性别的糖尿病患者多种饮食模式对全因死亡的影响和差异。方法分析来自美国国家健康和营养检查调查(National Health and Nutrition Examination Survey,NHANES)数据库中20002名参与者(3737名糖尿病患者)。用COX比例风险回归模型分析饮食质量评分与不同性别糖尿病患者全因死亡的关系。分层分析评估其他因素是否与饮食模式评分有相互作用。结果在74个月的中位随访期内,有512例死亡记录,男性311例,女性201例。饮食评分较高的糖尿病患者组对比较低组调整风险比如下:饮食炎症指数[男性:风险比(hazard ratio,HR)=1.22,P=0.084;女性HR=1.00,P=0.818];地中海饮食评分(男性:HR=0.99,P=0.873;女性HR=0.79,P=0.027);健康饮食指数-2020(男性HR=1.00,P=0.956;女性HR=0.83,P=0.046)。饮食评分对糖尿病患者死亡风险的影响是独立的,未发现饮食评分与其他变量存在内在的相互作用。结论糖尿病人群中,地中海饮食和健康饮食指数-2020与女性较低的死亡风险相关,而在男性未发现明显的关联。
文摘目的:研究“互联网+”模式对3~6岁儿童肥胖相关饮食行为的干预效果。方法:采用整群随机抽样方法抽取南充市顺庆区4所条件基本相同的幼儿园中2018年6~12月在南充市中心医院儿童保健门诊就诊的3~6岁单纯性肥胖儿童96例,随机分为试验组46例,对照组50例,试验组进行常规儿童保健+饮食行为干预+“互联网+”干预+个案管理,对照组进行常规儿童保健+饮食行为干预,1年后观察两组儿童干预效果,包括身高、体质量、腰围、体质量指数(body mass index,BMI)、体脂百分比等。结果:干预前两组儿童身高、体质量、腰围、体质指数、体脂百分比比较差异无统计学意义(P>0.05),干预后两组儿童各指标均明显改善(P<0.05),试验组改善更明显(P<0.01)。结论“:互联网+”模式下3~6岁儿童肥胖相关饮食行为干预相比传统线下干预模式效更显著,可以更好达到预防、干预、控制肥胖的目的。
文摘目的:基于CiteSpace和VOSviewer可视化软件对饮食限制(DR)调控炎症文献进行定量可视化分析,探索DR调控炎症领域的研究热点和趋势。方法:检索2010年1月1日至2022年9月29日Web of Science核心数据库中收录的DR调控炎症相关文献共1678篇,经筛查最终获得1344篇,使用CiteSpace和VOSviewer可视化软件对检索到的文献数据进行年发文量、国家、机构、作者、被引频次和关键词的定量和可视化分析。结果:最终获得的1344篇文献年发文量总体呈上升趋势,文献最高被引频次为1676次,美国(481篇)是出产文献数量最多的国家,中国(181篇)位居第二。DR调控炎症领域研究热点集中在热量限制(CR)、生酮饮食、衰老、代谢性疾病、脂肪组织及肠道菌群等方面。结论:DR调控炎症愈来愈受到国际和国内研究者青睐,未来研究热点可能是CR模拟物(CRM)、肠道菌群、神经退行性疾病和心血管疾病,总体研究趋势为进一步明确DR的抗炎机制,寻找新的治疗靶点,将更多经过体外和动物模型证实的有效方案进行更严格的临床试验。
