Risk of obesity during a gluten-free diet in pediatric and adult patients with celiac disease: a systematic review with meta-analysis

被引:14
作者
Barone, Michele [1 ]
Iannone, Andrea [1 ]
Cristofori, Fernanda [2 ]
Dargenio, Vanessa Nadia [2 ]
Indrio, Flavia [3 ]
Verduci, Elvira [4 ]
Di Leo, Alfredo [1 ]
Francavilla, Ruggiero [2 ]
机构
[1] Univ Bari Aldo Moro, Dept Emergency & Organ Transplantat, Gastroenterol Unit, Bari, Italy
[2] Univ Bari Aldo Moro, Interdisciplinary Dept Med, Pediat Sect, Bari, Italy
[3] IRCCS Casa Sollievo Sofferenza, Dept Pediat, Foggia, Italy
[4] Osped Bambini Vittore Buzzi, Dept Pediat, Milan, Italy
关键词
body mass index; body weight category; celiac disease; weight gain; BODY-MASS INDEX; CARDIOVASCULAR RISK; CHILDREN; OVERWEIGHT; POPULATION; WEIGHT; IMPACT; PREVALENCE; FEATURES;
D O I
10.1093/nutrit/nuac052
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Context Obesity is a significant risk factor for many pathological conditions. Whether a gluten-free diet (GFD) is a risk factor for overweight or obesity remains controversial. Objective The primary aim of this study was to assess the prevalence of body mass index (BMI) categories at disease presentation and the variation in BMI category from underweight/normal to overweight/obese and vice versa during a GFD. Data Sources PubMed, Scopus, and Web of Science databases were searched through February 2021 for retrospective, cross-sectional, and prospective studies reporting BMI categories at disease diagnosis and during a GFD. Data Extraction Data were extracted by 2 reviewers independently. Disagreements were resolved by consensus; a third reviewer was consulted, if necessary. Risk of bias was assessed with the Cochrane ROBINS-I tool. Data Analysis Subgroup analysis based on age (pediatric/adult patients), study design (prospective, cross-sectional, retrospective), and duration of GFD was performed.. Forty-five studies were selected (7959 patients with celiac disease and 20 524 healthy controls). The mean BMI of celiac patients at presentation was significantly lower than that of controls (P < 0.001). During a GFD, the mean BMI increased significantly (mean difference = 1.14 kg/m(2) [95%CI, 0.68-1.60 kg/m(2)]; I-2 = 82.8%; P < 0.001), but only 9% of patients (95%CI, 7%-12%; I-2 = 80.0%) changed from the underweight/normal BMI category to the overweight/obese category, while 20% (95%CI, 11%-29%; I-2 = 85.8%) moved into a lower BMI category. Conclusion Most celiac patients had a normal BMI at presentation, although the mean BMI was significantly lower than that of controls. A GFD does not increase the risk of becoming overweight/obese, especially in children. The quality of several studies was suboptimal, with moderate or high overall risk of bias and heterogeneity.
引用
收藏
页码:252 / 266
页数:15
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