Younger age at diagnosis predisposes to mucosal recovery in celiac disease on a gluten-free diet: A meta-analysis
Publication Date
November 02, 2017
Authors
Zsolt Szakács, Péter Mátrai, Péter Hegyi, Imre Szabó, et al
Volume
12
Issue
11
Pages
e0187526
DOI
https://dx.plos.org/10.1371/journal.pone.0187526
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0187526
Scopus
85033402515
Mendeley
http://www.mendeley.com/research/younger-age-diagnosis-predisposes-mucosal-recovery-celiac-disease-glutenfree-diet-metaanalysis
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Mendeley | Further Information

{"title"=>"Younger age at diagnosis predisposes to mucosal recovery in celiac disease on a gluten-free diet: A meta-analysis", "type"=>"journal", "authors"=>[{"first_name"=>"Zsolt", "last_name"=>"Szakács", "scopus_author_id"=>"57196451650"}, {"first_name"=>"Péter", "last_name"=>"Mátrai", "scopus_author_id"=>"57192010717"}, {"first_name"=>"Péter", "last_name"=>"Hegyi", "scopus_author_id"=>"56219159700"}, {"first_name"=>"Imre", "last_name"=>"Szabó", "scopus_author_id"=>"55599205600"}, {"first_name"=>"Áron", "last_name"=>"Vincze", "scopus_author_id"=>"7006066705"}, {"first_name"=>"Márta", "last_name"=>"Balaskó", "scopus_author_id"=>"7003326765"}, {"first_name"=>"Bernadett", "last_name"=>"Mosdósi", "scopus_author_id"=>"6505824027"}, {"first_name"=>"Patrícia", "last_name"=>"Sarlós", "scopus_author_id"=>"22136326200"}, {"first_name"=>"Mária", "last_name"=>"Simon", "scopus_author_id"=>"57196450366"}, {"first_name"=>"Katalin", "last_name"=>"Márta", "scopus_author_id"=>"57191620104"}, {"first_name"=>"Alexandra", "last_name"=>"Mikó", "scopus_author_id"=>"55847719000"}, {"first_name"=>"Dániel", "last_name"=>"Pécsi", "scopus_author_id"=>"57191614786"}, {"first_name"=>"Alexandra", "last_name"=>"Demcsák", "scopus_author_id"=>"57191675897"}, {"first_name"=>"Judit", "last_name"=>"Bajor", "scopus_author_id"=>"6602897204"}], "year"=>2017, "source"=>"PLoS ONE", "identifiers"=>{"doi"=>"10.1371/journal.pone.0187526", "sgr"=>"85033402515", "issn"=>"19326203", "pui"=>"619091740", "isbn"=>"1111111111", "pmid"=>"29095937", "scopus"=>"2-s2.0-85033402515"}, "id"=>"1f7e4166-5528-36de-ad5a-b56e40aba531", "abstract"=>"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.", "link"=>"http://www.mendeley.com/research/younger-age-diagnosis-predisposes-mucosal-recovery-celiac-disease-glutenfree-diet-metaanalysis", "reader_count"=>13, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Professor > Associate Professor"=>3, "Student > Doctoral Student"=>1, "Researcher"=>1, "Student > Ph. D. Student"=>3, "Student > Master"=>2, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Professor > Associate Professor"=>3, "Student > Doctoral Student"=>1, "Researcher"=>1, "Student > Ph. D. Student"=>3, "Student > Master"=>2, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>4, "Engineering"=>1, "Nursing and Health Professions"=>2, "Medicine and Dentistry"=>3, "Neuroscience"=>1, "Psychology"=>1, "Social Sciences"=>1}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>3}, "Neuroscience"=>{"Neuroscience"=>1}, "Social Sciences"=>{"Social Sciences"=>1}, "Psychology"=>{"Psychology"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Unspecified"=>{"Unspecified"=>4}}, "group_count"=>0}

Scopus | Further Information

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