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2.
Mayo Clin Proc ; 94(12): 2556-2571, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31806106

RESUMO

Celiac disease (CD) affects approximately 1% of the general population, although most cases remain unrecognized. Because CD is a multisystem disorder with protean clinical manifestations, a high index of suspicion is needed to make an appropriate diagnosis. A diagnosis of CD is made in a patient who is genetically predisposed based on the presence of compatible clinical features, positive highly specific celiac serologic findings, duodenal biopsies that document enteropathy, and improvement with a gluten-free diet. The differential diagnoses for the clinical features and the histologic findings seen in patients with CD are numerous and need to be considered; because the management of celiac disease consists of a lifelong gluten-free diet, ensuring that the diagnosis is correctly established is of utmost importance. The aim of this review is to provide practicing clinicians with the most current information on the diagnosis and management of CD, including new developments and the approach to controversial issues.


Assuntos
Doença Celíaca , Doença Celíaca/diagnóstico , Doença Celíaca/etiologia , Doença Celíaca/terapia , Humanos
3.
JAMA ; 322(6): 514-523, 2019 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-31408136

RESUMO

Importance: High gluten intake during childhood may confer risk of celiac disease. Objectives: To investigate if the amount of gluten intake is associated with celiac disease autoimmunity and celiac disease in genetically at-risk children. Design, Setting, and Participants: The participants in The Environmental Determinants of Diabetes in the Young (TEDDY), a prospective observational birth cohort study designed to identify environmental triggers of type 1 diabetes and celiac disease, were followed up at 6 clinical centers in Finland, Germany, Sweden, and the United States. Between 2004 and 2010, 8676 newborns carrying HLA antigen genotypes associated with type 1 diabetes and celiac disease were enrolled. Screening for celiac disease with tissue transglutaminase autoantibodies was performed annually in 6757 children from the age of 2 years. Data on gluten intake were available in 6605 children (98%) by September 30, 2017. Exposures: Gluten intake was estimated from 3-day food records collected at ages 6, 9, and 12 months and biannually thereafter until the age of 5 years. Main Outcomes and Measures: The primary outcome was celiac disease autoimmunity, defined as positive tissue transglutaminase autoantibodies found in 2 consecutive serum samples. The secondary outcome was celiac disease confirmed by intestinal biopsy or persistently high tissue transglutaminase autoantibody levels. Results: Of the 6605 children (49% females; median follow-up: 9.0 years [interquartile range, 8.0-10.0 years]), 1216 (18%) developed celiac disease autoimmunity and 447 (7%) developed celiac disease. The incidence for both outcomes peaked at the age of 2 to 3 years. Daily gluten intake was associated with higher risk of celiac disease autoimmunity for every 1-g/d increase in gluten consumption (hazard ratio [HR], 1.30 [95% CI, 1.22-1.38]; absolute risk by the age of 3 years if the reference amount of gluten was consumed, 28.1%; absolute risk if gluten intake was 1-g/d higher than the reference amount, 34.2%; absolute risk difference, 6.1% [95% CI, 4.5%-7.7%]). Daily gluten intake was associated with higher risk of celiac disease for every 1-g/d increase in gluten consumption (HR, 1.50 [95% CI, 1.35-1.66]; absolute risk by age of 3 years if the reference amount of gluten was consumed, 20.7%; absolute risk if gluten intake was 1-g/d higher than the reference amount, 27.9%; absolute risk difference, 7.2% [95% CI, 6.1%-8.3%]). Conclusions and Relevance: Higher gluten intake during the first 5 years of life was associated with increased risk of celiac disease autoimmunity and celiac disease among genetically predisposed children.


Assuntos
Autoanticorpos/sangue , Doença Celíaca/etiologia , Proteínas na Dieta/efeitos adversos , Predisposição Genética para Doença , Glutens/efeitos adversos , Transglutaminases/imunologia , Autoimunidade , Doença Celíaca/epidemiologia , Doença Celíaca/genética , Doença Celíaca/imunologia , Pré-Escolar , Diabetes Mellitus Tipo 1/etiologia , Diabetes Mellitus Tipo 1/genética , Registros de Dieta , Feminino , Glutens/administração & dosagem , Humanos , Incidência , Lactente , Masculino , Estudos Prospectivos , Risco
4.
Nutrients ; 11(7)2019 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-31337023

RESUMO

BACKGROUND: A strictly gluten-free diet (GFD) is the basis for managing celiac disease (CD). Numerous studies have reported nutritional deficiencies/imbalances ascribable to a GFD. The aim of this review is to describe nutritional deficiencies observed in children with celiac disease on a GFD, to discuss the clinical consequences related to these nutritional imbalances, and to identify strategies that may be adopted to treat them. METHODS: We reviewed the MEDLINE and EMBASE databases between January 1998 and January 2019. RESULTS: Children are, regardless of whether they are on a gluten-free diet or not, at risk of consuming too much fat and insufficient fiber, iron, vitamin D, and calcium. These imbalances may be exacerbated when children are on a gluten-free diet. In particular, the intake of folate, magnesium, zinc, and foods with a high glycemic index in children with CD who are on a GFD is significantly altered. CONCLUSIONS: Therapeutic protocols should include nutritional education to help teach subjects affected by disorders such as CD the importance of labels, the choice of foods, and the combination of macro- and micronutrients. Children with CD on a GFD should be encouraged to rotate pseudo-cereals, consume gluten-free commercial products that have been fortified or enriched, and use foods that are local and naturally gluten-free.


Assuntos
Doença Celíaca/etiologia , Transtornos da Nutrição Infantil/etiologia , Dieta Livre de Glúten/efeitos adversos , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Humanos
6.
Gastroenterol Clin North Am ; 48(2): 199-220, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31046971

RESUMO

This article presents the most common gastrointestinal, hepatic, and pancreatic manifestations of the primary immunodeficiency diseases, including the appropriate laboratory testing, endoscopic evaluation, and recommendations for further management.


Assuntos
Gastroenteropatias/etiologia , /complicações , Doença Celíaca/etiologia , Disenteria/etiologia , Hepatite A/etiologia , Hepatite Autoimune/etiologia , Humanos , Hiperplasia/etiologia , Doenças Inflamatórias Intestinais/etiologia , Linfonodos/patologia , Transtornos Linfoproliferativos/etiologia , Desnutrição/etiologia
7.
Am J Clin Nutr ; 109(Suppl_7): 838S-851S, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30982875

RESUMO

BACKGROUND: During the Pregnancy and Birth to 24 Months Project, the USDA and US Department of Health and Human Services initiated an evidence review on diet and health in these populations. OBJECTIVE: The aim of these systematic reviews was to examine the relationships of never versus ever feeding human milk, shorter versus longer durations of any and exclusive human milk feeding, and feeding a lower versus a higher intensity of human milk to mixed-fed infants with diagnosed celiac disease and inflammatory bowel disease (IBD). METHODS: The Nutrition Evidence Systematic Review team (formerly called the Nutrition Evidence Library) conducted systematic reviews with external experts. We searched CINAHL, Cochrane, Embase, and PubMed for articles published January, 1980 to March, 2016, dual-screened the results using predetermined criteria, extracted data from and assessed risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence. RESULTS: We included 9 celiac disease and 17 IBD articles. Limited case-control evidence suggests never versus ever being fed human milk is associated with higher risk of celiac disease, but concerns about reverse causality precluded a conclusion about the relationship of shorter versus longer durations of any human milk feeding with celiac disease. Evidence examining never versus ever feeding human milk and IBD was inconclusive, and limited, but consistent, case-control evidence suggests that, among infants fed human milk, shorter versus longer durations of any human milk feeding are associated with higher risk of IBD. For both outcomes, evidence examining the duration of exclusive human milk feeding was scant and no articles examined the intensity of human milk fed to mixed-fed infants. CONCLUSION: Limited case-control evidence suggests that feeding human milk for short durations or not at all associates with higher risk of diagnosed IBD and celiac disease, respectively. The small number of studies and concern about reverse causality and recall bias prevent stronger conclusions.


Assuntos
Doença Celíaca , Dieta , Comportamento Alimentar , Fórmulas Infantis , Doenças Inflamatórias Intestinais , Leite Humano , Aleitamento Materno , Doença Celíaca/etiologia , Doença Celíaca/prevenção & controle , Criança , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Doenças Inflamatórias Intestinais/etiologia , Doenças Inflamatórias Intestinais/prevenção & controle
9.
PLoS One ; 14(2): e0211436, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30785904

RESUMO

Gliadin, a component of wheat gluten known to be an important factor in the etiology of celiac disease, is related to several other diseases through its enhancing effect on intestinal paracellular permeability. We investigated the significance of gliadin in non-steroidal anti-inflammatory drug (NSAID)-induced small-intestinal damage in mice. 7-week-old C57BL/6 male mice were divided into the following groups: standard diet group, in which mice were fed with wheat-containing standard rodent diet (CE-2); gluten-free diet group, in which mice were fed with gluten-free diet (AIN-76A); and gliadin-administered group, in which mice fed with gluten-free diet were administered with gliadin (~250 mg/kg BW). Each group was subdivided into negative, healthy control group and NSAID-treated group. To some mice fed with gluten-free diet and administered with gliadin, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor was administered for clarification of the significance of EGFR in NSAID-induced small intestinal damage and intestinal permeability. In mice fed with a gluten-free diet, indomethacin or diclofenac induced very mild mucosal damage in the small intestine compared with that in mice fed with a wheat-containing standard diet. Gliadin exacerbated the NSAID-induced small-intestinal damage in mice fed with a gluten-free diet. With the administration of indomethacin, MPO activity, a marker of neutrophil infiltration into the mucosa and mRNA expression level of tumor necrosis factor α and interleukin-1ß in the small intestine were higher in the gliadin-administered mice. Gliadin increased the intestinal paracellular permeability without indomethacin administration (4.3-fold) and further increased the permeability after indomethacin administration (2.1-fold). Gliadin induced phosphorylation of epidermal growth factor receptor (EGFR) in small-intestinal tissues, and erlotinib (an EGFR tyrosine kinase inhibitor) attenuated the indomethacin-induced intestinal damage and permeability exacerbated by gliadin, accompanied by inhibition of EGFR phosphorylation. These results suggest that gliadin plays an important role in the induction and exacerbation of NSAID-induced small-intestinal damage, and that increase in intestinal permeability via the EGFR signalling pathway is involved in its mechanism.


Assuntos
Gliadina/efeitos adversos , Intestino Delgado/efeitos dos fármacos , Intestino Delgado/fisiopatologia , Triticum/efeitos adversos , Animais , Anti-Inflamatórios não Esteroides/efeitos adversos , Doença Celíaca/etiologia , Diclofenaco/efeitos adversos , Dieta Livre de Glúten , Modelos Animais de Doenças , Receptores ErbB/antagonistas & inibidores , Receptores ErbB/fisiologia , Cloridrato de Erlotinib/farmacologia , Glutens/efeitos adversos , Indometacina/efeitos adversos , Mucosa Intestinal/efeitos dos fármacos , Mucosa Intestinal/patologia , Mucosa Intestinal/fisiopatologia , Intestino Delgado/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Permeabilidade/efeitos dos fármacos , Fosforilação , Inibidores de Proteínas Quinases/farmacologia
10.
Gastroenterol Clin North Am ; 48(1): 1-18, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30711202

RESUMO

Celiac disease is a common, chronic inflammatory disorder of the small intestine triggered by exposure to gluten in individuals with certain genetic types. This disorder affects people of any age or gender. Although often thought to be European in origin, it is now global in extent. Presentations are variable, from asymptomatic patients to severe malnutrition. Initial detection usually relies on celiac-specific serology, and confirmation often requires intestinal biopsy. There have been substantial increases in prevalence and incidence over the last 2 decades for reasons that are almost certainly environmental but for which there is no clarity as to cause.


Assuntos
Doença Celíaca/epidemiologia , Doença Celíaca/etiologia , Biópsia , Doença Celíaca/diagnóstico , Doença Celíaca/patologia , Meio Ambiente , Feminino , Glutens/efeitos adversos , Antígenos HLA-DQ , Humanos , Incidência , Intestino Delgado/imunologia , Intestino Delgado/patologia , Masculino , Gravidez , Prevalência , Fatores de Risco , Testes Sorológicos , Fatores Sexuais
11.
Gastroenterol Clin North Am ; 48(1): 101-113, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30711203

RESUMO

Celiac disease, once thought to be very uncommon in Asia, is now emerging in many Asian countries. Although the absolute number of patients with celiac disease at present is not very high, this number is expected to increase markedly over the next few years/decades owing to increasing awareness. It is now that the medical community across the Asia should define the extent of the problem and prepare to handle the impending epidemic of celiac disease in Asia.


Assuntos
Doença Celíaca/epidemiologia , Ásia/epidemiologia , Conscientização , Doença Celíaca/diagnóstico , Doença Celíaca/dietoterapia , Doença Celíaca/etiologia , Dieta Livre de Glúten , Rotulagem de Alimentos/legislação & jurisprudência , Glutens/efeitos adversos , Antígenos HLA-DQ , Humanos , Nutricionistas/educação , Médicos de Atenção Primária , Prevalência , Grupos de Autoajuda , Testes Sorológicos
12.
Gastroenterol Clin North Am ; 48(1): 115-126, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30711204

RESUMO

The healthy microbiome is necessary for normal immune development in the gut. Alterations in the microbial makeup after a critical window increase the risk of autoimmunity, including celiac disease. Although this dysbiosis has been described in adult and pediatric patients, factors leading to dysbiosis are still being elucidated. Genetics has some role in determining the microbiome makeup of the host, but other factors have yet to be determined. The microbiome remains an important therapeutic target in many autoimmune conditions, including celiac disease, however studies have yet to determine the ideal replacement therapy to correct the dysbiosis.


Assuntos
Doença Celíaca/microbiologia , Doença Celíaca/terapia , Microbioma Gastrointestinal/fisiologia , Probióticos/uso terapêutico , Doença Celíaca/etiologia , Doença Celíaca/imunologia , Homeostase/imunologia , Humanos , Prebióticos
13.
Gastroenterol Clin North Am ; 48(1): 137-144, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30711206

RESUMO

Refractory celiac disease (RCD) refers to persistence of malnutrition and intestinal villous atrophy for more than 1 to 2 years despite strict gluten-free diet in patients with celiac disease. Diagnosis remains difficult and impacts treatment and follow-up. RCD has been subdivided into 2 subgroups according to the normal (RCDI) or abnormal phenotype of intraepithelial lymphocytes (IELs) (RCDII). RCDII is considered as a low-grade intraepithelial lymphoma and has a poor prognosis due to gastrointestinal and extraintestinal dissemination of the abnormal IELs, and high risk of overt lymphoma.


Assuntos
Budesonida/administração & dosagem , Doença Celíaca/diagnóstico , Doença Celíaca/terapia , Doença Celíaca/etiologia , Doença Celíaca/patologia , Endoscopia Gastrointestinal , Citometria de Fluxo , Humanos , Imuno-Histoquímica , Intestino Delgado/citologia , Intestino Delgado/diagnóstico por imagem , Intestino Delgado/patologia , Linfócitos Intraepiteliais/imunologia , Linfócitos Intraepiteliais/patologia , Desnutrição/etiologia , Prognóstico , Risco , Índice de Gravidade de Doença
14.
Gastroenterol Clin North Am ; 48(1): 145-163, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30711207

RESUMO

Celiac disease (CD) is an autoimmune enteropathy triggered by gluten. Gluten-free diets can be challenging because of their restrictive nature, inadvertent cross-contaminations, and the high cost of gluten-free food. Novel nondietary therapies are at the preclinical stage, clinical trial phase, or have already been developed for other indications and are now being applied to CD. These therapies include enzymatic gluten degradation, binding and sequestration of gluten, restoration of epithelial tight junction barrier function, inhibition of tissue transglutaminase-mediated potentiation of gliadin oligopeptide immunogenicity or of human leukocyte antigen-mediated gliadin presentation, induction of tolerance to gluten, and antiinflammatory interventions.


Assuntos
Doença Celíaca/etiologia , Doença Celíaca/terapia , Terapia Combinada , Terapia de Alvo Molecular , Autoimunidade , Bifidobacterium longum subspecies infantis , Doença Celíaca/imunologia , Dieta Livre de Glúten , Antígenos HLA-DQ , Humanos , Fatores Imunológicos/administração & dosagem , Lactococcus lactis , Oligopeptídeos/administração & dosagem , Pancrelipase/administração & dosagem , Peptídeo Hidrolases/administração & dosagem , Probióticos/administração & dosagem , Sulfonamidas/administração & dosagem
15.
Gastroenterol Clin North Am ; 48(1): 53-72, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30711211

RESUMO

Celiac disease (CD) is an autoimmune-related disease causing inflammation in the small intestine triggered by the ingestion of gluten in the diet. The gluten-free diet (GFD) is the only treatment. Nutritional deficiencies of macronutrients and micronutrients are frequently found in untreated or newly diagnosed CD. A registered dietitian nutritionist is uniquely qualified to educate on the GFD and assess and support nutritional status at diagnosis and long term as well as helping patients with nonresponsive CD. Quality of life is important to address in individuals with CD because the GFD affects all aspects of life.


Assuntos
Doença Celíaca/dietoterapia , Doença Celíaca/fisiopatologia , Dieta Livre de Glúten , Fenômenos Fisiológicos da Nutrição , Doença Celíaca/diagnóstico , Doença Celíaca/etiologia , Microbioma Gastrointestinal , Humanos , Intestino Delgado/microbiologia , Desnutrição , Estado Nutricional , Nutricionistas , Educação de Pacientes como Assunto , Papel Profissional , Qualidade de Vida
18.
Front Immunol ; 10: 31, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30761127

RESUMO

Celiac disease (CD) is a chronic enteropathy elicited by a Th1 response to gluten peptides in the small intestine of genetically susceptible individuals. However, it remains unclear what drives the induction of inflammatory responses of this kind against harmless antigens in food. In a recent work, we have shown that the p31-43 peptide (p31-43) from α-gliadin can induce an innate immune response in the intestine and that this may initiate pathological adaptive immunity. The receptors and mechanisms responsible for the induction of innate immunity by p31-43 are unknown and here we present evidence that this may reflect conformational changes in the peptide that allow it to activate the NLRP3 inflammasome. Administration of p31-43, but not scrambled or inverted peptides, to normal mice induced enteropathy in the proximal small intestine, associated with increased production of type I interferon and mature IL-1ß. P31-43 showed a sequence-specific spontaneous ability to form structured oligomers and aggregates in vitro and induced activation of the ASC speck complex. In parallel, the enteropathy induced by p31-43 in vivo did not occur in the absence of NLRP3 or caspase 1 and was inhibited by administration of the caspase 1 inhibitor Ac-YVAD-cmk. Collectively, these findings show that p31-43 gliadin has an intrinsic propensity to form oligomers which trigger the NLRP3 inflammasome and that this pathway is required for intestinal inflammation and pathology when p31-43 is administered orally to mice. This innate activation of the inflammasome may have important implications in the initial stages of CD pathogenesis.


Assuntos
Caspase 1/metabolismo , Gliadina/metabolismo , Inflamassomos/metabolismo , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patologia , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Fragmentos de Peptídeos/metabolismo , Multimerização Proteica , Sequência de Aminoácidos , Animais , Apoptose , Doença Celíaca/etiologia , Doença Celíaca/metabolismo , Modelos Animais de Doenças , Suscetibilidade a Doenças , Gliadina/química , Gliadina/ultraestrutura , Mucosa Intestinal/ultraestrutura , Intestino Delgado , Masculino , Camundongos , Camundongos Transgênicos , Modelos Moleculares , Proteína 3 que Contém Domínio de Pirina da Família NLR/genética , Fragmentos de Peptídeos/química , Fragmentos de Peptídeos/ultraestrutura , Conformação Proteica , Relação Estrutura-Atividade
19.
Saudi Med J ; 40(1): 9-18, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30617375

RESUMO

OBJECTIVES: To perform a meta-analysis for celiac diseases (CD) among at-risk populations in Kingdom of Saudi Arabia (KSA), as well as a comparison with our previously reported meta-analysis in the normal population. METHODS: In March 2018, at King Abdulaziz University,  Jeddah, KSA we commenced a retrospective comprehensive database and journal search for CD among at-risk populations in SA. Data from each of the relevant articles were analyzed using the  Statistical Package for Social Science Version 20 (Armonk, NY: IBM Corp.). and the comprehensive meta-analysis program (CMA). The collected data were part of a retrospective literature review and analysis. Thus, a written ethical approval was not obtained before commencing the study. Results: Sixteen articles were found covering type-1 diabetes mellitus (DM), short stature (SS), and down syndrome (DS). Ages 1-50 years . The prevalence of seropositive-CD was 15.6% with high heterogeneity (I2=80.353), while prevalence of biopsy-proven CD was 10.6% with high heterogeneity (I2=73.359). Another article reported the CD prevalence in the at-risk population as 18.4% for the seroprevalence and  6.9% for the biopsy-proven CD. Anti-transglutaminase (anti-tTG) was used in 12 studies; in the remaining 4 studies (EMA in 2, ARA with AGA in one and no details given in one study). Conclusion: Both the prevalence of biopsy-proven CD (10.6%) and seroprevalence (15.6%) were higher than those we previously reported in the normal population (1.4% and 2.7%). The female-to-male ratio (1.9/1) of CD patients was the same in normal and at-risk populations in SA. Meta-analysis for prevalence of CD in DM, SS, and DS separately in SA is recommended.


Assuntos
Doença Celíaca/epidemiologia , Fatores de Risco , Adolescente , Adulto , Biópsia , Estatura , Doença Celíaca/etiologia , Doença Celíaca/patologia , Criança , Pré-Escolar , Diabetes Mellitus Tipo 1 , Síndrome de Down , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Arábia Saudita/epidemiologia , Estudos Soroepidemiológicos , Fatores Sexuais , Adulto Jovem
20.
Korean J Intern Med ; 34(1): 90-98, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29172402

RESUMO

BACKGROUND/AIMS: Olmesartan, a widely used angiotensin II receptor blocker (ARB), has been linked to sprue-like enteropathy. No cases of olmesartan-associated enteropathy have been reported in Northeast Asia. We investigated the associations between olmesartan and other ARBs and the incidence of enteropathy in Korea. METHODS: Our retrospective cohort study used data from the Korean National Health Insurance Service to identify 108,559 patients (58,186 females) who were initiated on angiotensin converting enzyme inhibitors (ACEis), olmesartan, or other ARBs between January 2005 and December 2012. The incidences of enteropathy were compared among drug groups. Changes in body weight were compared after propensity score matching of patients in the ACEis and olmesartan groups. RESULTS: Among 108,559 patients, 31 patients were diagnosed with enteropathy. The incidences were 0.73, 0.24, and 0.37 per 1,000 persons, in the ACEis, olmesartan, and other ARBs groups, respectively. Adjusted rate ratios for enteropathy were: olmesartan, 0.33 (95% confidential interval [CI], 0.10 to 1.09; p = 0.070) and other ARBs, 0.34 (95% CI, 0.14 to 0.83; p = 0.017) compared to the ACEis group after adjustment for age, sex, income level, and various comorbidities. The post hoc analysis with matched cohorts revealed that the proportion of patients with significant weight loss did not differ between the ACEis and olmesartan groups. CONCLUSION: Olmesartan was not associated with intestinal malabsorption or significant body weight loss in the general Korean population. Additional large-scale prospective studies of the relationship between olmesartan and the incidence of enteropathy in the Asian population are needed.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/efeitos adversos , Imidazóis/efeitos adversos , Enteropatias/etiologia , Tetrazóis/efeitos adversos , Adulto , Idoso , Inibidores da Enzima Conversora de Angiotensina/efeitos adversos , Doença Celíaca/epidemiologia , Doença Celíaca/etiologia , Estudos de Coortes , Feminino , Humanos , Incidência , Enteropatias/epidemiologia , Síndromes de Malabsorção/epidemiologia , Síndromes de Malabsorção/etiologia , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco
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