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Volume 147, Issue 3, Pages e1 (September 2014)

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1 Volume 147, Issue 3, Pages 610-617.e1 (September 2014)
Benefits of a Gluten-Free Diet for Asymptomatic Patients With Serologic Markers of Celiac Disease  Kalle Kurppa, Aku Paavola, Pekka Collin, Harri Sievänen, Kaija Laurila, Heini Huhtala, Päivi Saavalainen, Markku Mäki, Katri Kaukinen  Gastroenterology  Volume 147, Issue 3, Pages e1 (September 2014) DOI: /j.gastro Copyright © 2014 AGA Institute Terms and Conditions

2 Figure 1 (A and B) Serum EmA and TG2ab antibodies, (C) VAS, and (D) small-bowel mucosal Vh/CrD. The results are shown at baseline and after 1 and 2 years of study enrollment. The solid line denotes the GFD group on a gluten-free diet and the dashed line shows the gluten group on a gluten-containing (from baseline to 1 year) or on a gluten-free diet (from 1 to 2 years). The dotted line denotes (A and B) upper or (D) lower reference limits for normal. The values are expressed as the (A) unadjusted median and quartiles or (B–D) means and 95% confidence intervals. There was a significant difference in the changes between the randomization groups after 1 year in EmA (P = .003) and TG2ab (P = .003), in the perception of health by VAS (P = .017), and in the Vh/CrD (P < .001). On the VAS, the scale ranges from 0 to 100 mm and higher values indicate better subjective perception of current health. In Vh/CrD ratios, greater than 2.0 indicates normal small-bowel mucosal morphology. Gastroenterology  , e1DOI: ( /j.gastro ) Copyright © 2014 AGA Institute Terms and Conditions

3 Figure 2 Absolute differences between the study groups in changes in the (A) GSRS, (B) PGWB, and (C) SF-36 scores. The differences in changes between the intervention group (GFD) and the normal diet group (gluten) are shown after 1 year of study enrollment and are expressed as means and 95% confidence intervals. On the GSRS, higher scores denote more severe gastrointestinal symptoms, on the PGWB higher scores denote better self-perceived quality of life, and on the SF-36 higher scores denote better health status and quality of life. Values in each subdimension scores are calculated as a mean of the relevant items. EP, emotional problems; PP, physical problems. Gastroenterology  , e1DOI: ( /j.gastro ) Copyright © 2014 AGA Institute Terms and Conditions

4 Supplementary Figure 1 Enrollment, randomization, and follow-up evaluation of the study patients. *Exclusion criteria of the study were as follows: previous diagnosis of celiac disease, age younger than 18 years, evident clinical symptoms, dietary gluten restriction, severe contemporary illness, pregnancy, immunosuppressive medication, and study refusal. †One subject started a gluten-free diet soon after randomization, but was assigned to the gluten group according to an intention-to-treat principle. ‡The subjects remained on a gluten-free diet. Gastroenterology  , e1DOI: ( /j.gastro ) Copyright © 2014 AGA Institute Terms and Conditions


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