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001-es BibID:BIBFORM056540
Első szerző:Vriezinga, Sabine Lisa
Cím:Randomized feeding intervention in infants at high risk for celiac disease / S. L. Vriezinga, R. Auricchio, E. Bravi, G. Castillejo, A. Chmielewska, P. Crespo Escobar, S. Kolaček, S. Koletzko, I. R. Korponay-Szabo, E. Mummert, I. Polanco, H. Putter, C. Ribes-Koninckx, R. Shamir, H. Szajewska, K. Werkstetter, L. Greco, J. Gyimesi, C. Hartman, C. Hogen Esch, E. Hopman, A. Ivarsson, T. Koltai, F. Koning, E. Martinez-Ojinaga, C. te Marvelde, A. Mocic Pavic, J. Romanos, E. Stoopman, V. Villanacci, C. Wijmenga, R. Troncone, M. L. Mearin
Dátum:2014
ISSN:0028-4793
Megjegyzések:BACKGROUND A window of opportunity has been suggested for reducing the risk of celiac disease by introducing gluten to infants at 4 to 6 months of age. METHODS We performed a multicenter, randomized, double-blind, placebo-controlled dietaryintervention study involving 944 children who were positive for HLA-DQ2 or HLADQ8 and had at least one first-degree relative with celiac disease. From 16 to 24 weeks of age, 475 participants received 100 mg of immunologically active gluten daily, and 469 received placebo. Anti-transglutaminase type 2 and antigliadin antibodies were periodically measured. The primary outcome was the frequency of biopsy-confirmed celiac disease at 3 years of age. RESULTS Celiac disease was confirmed by means of biopsies in 77 children. To avoid underestimation of the frequency of celiac disease, 3 additional children who received a diagnosis of celiac disease according to the 2012 European Society for Pediatric Gastroenterology, Hepatology, and Nutrition diagnostic criteria (without having undergone biopsies) were included in the analyses (80 children; median age, 2.8 years; 59% were girls). The cumulative incidence of celiac disease among patients 3 years of age was 5.2% (95% confidence interval [CI], 3.6 to 6.8), with similar rates in the gluten group and the placebo group (5.9% [95% CI, 3.7 to 8.1] and 4.5% [95% CI, 2.5 to 6.5], respectively; hazard ratio in the gluten group, 1.23; 95% CI, 0.79 to 1.91). Rates of elevated levels of anti-transglutaminase type 2 and antigliadin antibodies were also similar in the two study groups (7.0% [95% CI, 4.7 to 9.4] in the gluten group and 5.7% [95% CI, 3.5 to 7.9] in the placebo group; hazard ratio, 1.14; 95% CI, 0.76 to 1.73). Breast-feeding, regardless of whether it was exclusive or whether it was ongoing during gluten introduction, did not significantly influence the development of celiac disease or the effect of the intervention. CONCLUSIONS As compared with placebo, the introduction of small quantities of gluten at 16 to 24 weeks of age did not reduce the risk of celiac disease by 3 years of age in this group of high-risk children. (Funded by the European Commission and others; PreventCD Current Controlled Trials number, ISRCTN74582487.)
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:New England Journal Of Medicine 371 : 14 (2014), p. 1304-1315. -
További szerzők:Auricchio, Renata Bravi, Enzo (biológus) Castillejo, Gemma (gyermekgyógyász, gasztroenterológus) Chmielewska, Anna Crespo-Escobar, Paula Kolaček, Sanja Koletzko, Sibylle Korponay-Szabó Ilma (1959-) (gyermekgyógyász) Mummert, Eckart Polanco, Isabel Putter, Hein Ribes-Koninckx, Carmen Shamir, Raanan (gyermekgyógyász) Szajewska, Hania (gyermekgyógyász) Werkstetter, Katharina (gyermekgyógyász, gasztroenterológus) Greco, Luigi Gyimesi Judit Hartman, Corina Hogen Esch, Caroline Hopman, Erica Ivarsson, Anneli Koltai Tünde Koning, Frits Martinez-Ojinaga, Eva Marvelde, Chantal te Pavic, Ana Romanos, Jihane Stoopman, Els Villanacci, Vincenzo Wijmenga, Cisca Troncone, Riccardo Mearin, Maria Luisa
Pályázati támogatás:TÁMOP-2.2.11/1/KONV-2012-0023
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