El efecto de la dieta libre de gluten en la alaninaaminotransferasa (ALT) en pacientes celíacosThe effect of a gluten-free diet on alanine aminotransferase (ALT) in celiac patients ResumenIntroducción: la enfermedad celíaca es una enfermedad autoinmune provocada por la ingestión de gluten que afecta aproximadamente al 0,5%-1% de la población mundial. Las señales extraintestinales incluyen elevados niveles de alanina-aminotransferasa (ALT). Objetivo: evaluar los efectos de una dieta libre de gluten en los niveles ALT en pacientes con enfermedad celíaca. Métodos: este estudio transversal se llevó a cabo en la clínica ambulatoria de gastroenterología de un hospital universitario. Resultados: se incluyeron veintiséis pacientes con enfermedad celíaca con edad de 34,1 ± 11,4 años; 15,4% fueron hombres. Los sujetos del estudio tenían un nivel promedio de ALT de 54,6 ± 36,3 (mediana 40,5) U/L. Hubo una mayor proporción de individuos con hepatitis B en el grupo con ALT ≥50 U/L en comparación con sujetos con ALT <50 U/L. Entre los pacientes evaluados después del tratamiento con dieta libre de gluten se observó una reducción significativa de los valores de ALT (36,0 versus 31,0 U/l; p= 0,008). Conclusión: el treinta y cinco por ciento de los pacientes con enfermedad celíaca tenía ALT por encima del tercil superior. Se encontraron niveles más altos de ALT en pacientes con hepatitis viral B y en aquéllos que no se adhirieron a la dieta. Hubo una reducción de aminotransferasas como resultado de una dieta libre de gluten. Palabras claveTransaminasas, enfermedad celíaca, alanina-transaminasa, aminotransferasas aspartato, dieta, libre de gluten. AbstractIntroduction: Celiac disease is an autoimmune disease triggered by ingestion of gluten. It affects approximately 0.5% to 1% of the world population. Extra intestinal manifestations include elevated alanine aminotransferase (ALT) levels. Objective: The objective of this study was to evaluate the effects of a gluten-free diet on ALT levels in patients with celiac disease. Methods: This cross-sectional study was conducted in the gastroenterology outpatient clinic of a university hospital. Results: Twenty-six patients with celiac disease were included. Average patient age was 34.1 ± 11.4 years, and 15.4% of the patients were men. Study subjects had a mean ALT level of 54.6 ± 36.3 U/L (median 40.5). There was a higher proportion of individuals with hepatitis B in the group with ALT ≥ 50 U/L than in the group of subjects with ALT < 50 U/L. Among patients tested after treatment with a gluten-free diet, we observed a significant reduction in ALT values (36.0 vs. 31.0 U/L; P = 0.008). Conclusion: Thirty-five percent of celiac disease patients had ALT levels above the upper tertile. Higher ALT levels were found in patients with viral hepatitis B and in those who do not adhere to the diet. There was a reduction of aminotransferases with a gluten-free diet.
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