Abstract
Coeliac disease (CeD) is an immune-mediated inflammatory enteropathy triggered by the ingestion of gluten in genetically susceptible individuals. Gastrointestinal (GI) hormone response related to appetite and glucose metabolism is still under-investigated in patients with CeD. This study aimed at shedding light on the appetite sensations, glycaemia and hormone response induced by a complex meal in patients with coeliac disease. Twenty-two women with CeD, nine at the diagnosis (CeDD) and thirteen under a gluten-free diet (CeDGF), and ten healthy subjects (HS) were enrolled in a single day intervention study. All subjects consumed a test meal, recorded their appetite sensations, and blood was collected over three hours after meal consumption. The study found a lower decrease in hunger in CeDD compared to CeDGF and HS after meal intake. Data showed no difference of fullness and satiety between the groups. CeDD had lower insulin and glucose-dependent insulinotropic polypeptide (GIP) than CeDGF and HS. Both CeDD and CeDGF experienced a lower post-prandial response of glucose than HS. Data suggested that patients with CeD have an impaired glucose absorption after more than 12 months of gluten-free diet. Postprandial GIP may play a significant role in appetite cues and insulin response to a complex meal.
Highlights
The incidence of coeliac disease (CeD) has significantly increased over the recent decades especially among adults [1,2]
This study aimed to evaluate the post-prandial appetite sensations induced by a mixed meal in patients with CeD at diagnosis (CeDD) and on a gluten-free diet (GFD) (CeDGF) and to clarify the role of GI
The main finding of this study was that in the post-prandial phase CeDD showed a sustained hunger sensation and a reduced response of plasma glucose-dependent insulinotropic polypeptide (GIP) and insulin compared to CeDGF and healthy subjects (HS)
Summary
The incidence of coeliac disease (CeD) has significantly increased over the recent decades especially among adults [1,2]. The increased risk of overweight or obesity was reported in patients with CeD who were normal weight or overweight and even experiencing cholesterol levels below the normal range at diagnosis [6,7,8,9] This observation was associated with both the improved intestinal absorption induced by the GFD and to the unhealthy dietary behaviour adopted by CeD patients [10,11] who frequently have diets rich in lipids, sugars and proteins [12,13,14] as well as low in dietary fibre [12,13,15].
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