PMID- 28823009
OWN - NLM
STAT- MEDLINE
DCOM- 20190422
LR  - 20190422
IS  - 1435-5922 (Electronic)
IS  - 0944-1174 (Linking)
VI  - 53
IP  - 4
DP  - 2018 Apr
TI  - Proton pump inhibitors as risk factor for metabolic syndrome and hepatic 
      steatosis in coeliac disease patients on gluten-free diet.
PG  - 507-516
LID - 10.1007/s00535-017-1381-7 [doi]
AB  - BACKGROUND: Recent research has shown that patients with coeliac disease (CD) are 
      at risk of developing metabolic syndrome (MS) and hepatic steatosis (HS) after 
      commencing a gluten-free diet (GFD). This study aimed to evaluate the predictive 
      factors for MS and HS in CD after 1 year of GFD. METHODS: All consecutive newly 
      diagnosed CD patients were enrolled. We prospectively collected data about BMI; 
      waist circumference; blood pressure; cholesterol; triglycerides, glucose and 
      insulin blood levels; insulin resistance (through the homeostatic model 
      assessment HOMA-IR) and treatment with proton pump inhibitors (PPI). Diagnosis of 
      MS was made in accordance with current guidelines and HS was diagnosed by 
      ultrasonography. The prevalence of MS and HS was re-assessed after 1 year of GFD. 
      A logistic regression analysis was performed to identify risk factors for MS and 
      HS occurrence after 1 year of GFD. RESULTS: Of 301 patients with newly diagnosed 
      CD, 4.3% met criteria for diagnosis of MS and 25.9% presented with HS at the time 
      of CD diagnosis; 99 subjects (32.8%) had long-term exposure to PPI during the 
      study period. After 1 year, 72 (23.9%) patients had developed MS (4.3 vs 23.9%; 
      p < 0.001, OR 6.9) and 112 (37.2%) had developed HS (25.9 vs 37.2%; p < 0.01, OR 
      1.69). At multivariate analysis, high BMI at diagnosis (OR 10.8; p < 0.001) and 
      PPI exposure (OR 22.9; p < 0.001) were the only factors associated with the 
      occurrence of MS; HOMA-IR (OR 9.7; p < 0.001) and PPI exposure (OR 9.2; 
      p < 0.001) were the only factors associated with the occurrence of HS. 
      CONCLUSIONS: PPI exposure adds further risk of occurrence of MS and HS for 
      patients with CD on GFD. The use of PPI in patients with CD on GFD should be 
      limited to strict indications.
FAU - Imperatore, Nicola
AU  - Imperatore N
AUID- ORCID: 0000-0003-3230-6832
AD  - Gastroenterology, Department of Clinical Medicine and Surgery, School of Medicine 
      "Federico II" of Naples, Via S. Pansini 5, 80131, Naples, Italy. 
      nicola.imperatore@alice.it.
FAU - Tortora, Raffaella
AU  - Tortora R
AD  - Gastroenterology, Department of Clinical Medicine and Surgery, School of Medicine 
      "Federico II" of Naples, Via S. Pansini 5, 80131, Naples, Italy.
AD  - Hepatology Unit, AORN Cardarelli, Naples, Italy.
FAU - Testa, Anna
AU  - Testa A
AD  - Gastroenterology, Department of Clinical Medicine and Surgery, School of Medicine 
      "Federico II" of Naples, Via S. Pansini 5, 80131, Naples, Italy.
FAU - Gerbino, Nicolo
AU  - Gerbino N
AD  - Gastroenterology, Department of Clinical Medicine and Surgery, School of Medicine 
      "Federico II" of Naples, Via S. Pansini 5, 80131, Naples, Italy.
FAU - Caporaso, Nicola
AU  - Caporaso N
AD  - Gastroenterology, Department of Clinical Medicine and Surgery, School of Medicine 
      "Federico II" of Naples, Via S. Pansini 5, 80131, Naples, Italy.
FAU - Rispo, Antonio
AU  - Rispo A
AD  - Gastroenterology, Department of Clinical Medicine and Surgery, School of Medicine 
      "Federico II" of Naples, Via S. Pansini 5, 80131, Naples, Italy.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20170819
PL  - Japan
TA  - J Gastroenterol
JT  - Journal of gastroenterology
JID - 9430794
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
EIN - J Gastroenterol. 2017 Sep 19;:. PMID: 28929178
MH  - Adolescent
MH  - Adult
MH  - Anthropometry/methods
MH  - Body Mass Index
MH  - Celiac Disease/*complications/diet therapy
MH  - Diet, Gluten-Free/*adverse effects
MH  - Fatty Liver/*etiology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Metabolic Syndrome/*etiology
MH  - Middle Aged
MH  - Proton Pump Inhibitors/*adverse effects
MH  - Risk Factors
MH  - Young Adult
OTO - NOTNLM
OT  - Coeliac disease
OT  - Hepatic steatosis
OT  - Metabolic syndrome
OT  - Proton pump inhibitors
EDAT- 2017/08/22 06:00
MHDA- 2019/04/23 06:00
CRDT- 2017/08/21 06:00
PHST- 2017/05/11 00:00 [received]
PHST- 2017/08/08 00:00 [accepted]
PHST- 2017/08/22 06:00 [pubmed]
PHST- 2019/04/23 06:00 [medline]
PHST- 2017/08/21 06:00 [entrez]
AID - 10.1007/s00535-017-1381-7 [pii]
AID - 10.1007/s00535-017-1381-7 [doi]
PST - ppublish
SO  - J Gastroenterol. 2018 Apr;53(4):507-516. doi: 10.1007/s00535-017-1381-7. Epub 
      2017 Aug 19.