Search

Introduction: Celiac disease (CD) is associated with an increased risk of major depressive disorder, possibly due to deficiencies in micronutrients in the gluten-free diet. We aimed to investigate whether essential amino acids (i.e., the precursors of serotonin, dopamine and other neurotransmitters) are depleted in the diet and serum of CD patients with major depressive disorder., Methods: In a cross-sectional study we assessed dietary intake of amino acids and serum levels of amino acids, in 77 CD patients on a gluten-free diet and in 33 healthy controls. Major depressive disorder was assessed with structured interviews (using the Mini International Neuropsychiatric Interview Plus). Dietary intake was assessed using a 203-item food frequency questionnaire., Results: Participants had a mean age of 55 years and 74% were women. The intake of vegetable protein was significantly lower in CD patients than in healthy controls (mean difference of 7.8 g/d; 95% CI: 4.7-10.8), as were serum concentrations of tyrosine, phenylalanine and tryptophan (all p < 0.005). However, within the CD patient group, the presence of major depressive disorder (n = 42) was not associated with intake or serum levels of essential amino acids., Conclusions: Patients with CD on a long-term gluten-free diet, with good adherence, consume significantly less vegetable protein than controls, and their serum levels of several essential amino acids were also lower. Despite its potential adverse effect, intake and serum levels of essential amino acids were not related to major depression.

Objectives: Celiac disease (CD), a genetically predisposed intolerance for gluten, is associated with an increased risk of major depressive disorder (MDD). We investigated whether dietary intake and serum levels of the essential n-3 polyunsaturated fatty acids (PUFA) eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA) found in fatty fish play a role in this association., Methods: Cross-sectional study in 71 adult CD patients and 31 healthy volunteers, matched on age, gender and level of education, who were not using n-3 PUFA supplements. Dietary intake, as assessed using a 203-item food frequency questionnaire, and serum levels of EPA and DHA were compared in analyses of covariance, adjusting for potential confounders. Serum PUFA were determined using gas chromatography., Results: Mean serum DHA was significantly higher in CD patients (1.72 mass%) than controls (1.28 mass%) after multivariable adjustment (mean diff. 0.45 mass%; 95% CI: 0.22-0.68; p = 0.001). The mean intake of EPA plus DHA did not differ between CD patients and controls after multivariable adjustment (0.15 and 0.22 g/d, respectively; p = 0.10). There were no significant differences in intake or serum levels of EPA and DHA between any of the CD patient groups (never depressed, current MDD, minor/partially remitted MDD, remitted MDD) and controls., Conclusions: Patients on a long term gluten-free diet had similar intakes of EPA plus DHA compared to controls. Contrary to expectations, DHA serum levels were significantly higher in CD patients compared to healthy controls and were unrelated to MDD status.

Objectives: We aimed to investigate whether long-term adherence to a gluten-free diet is related to depressive symptoms in coeliac disease (CD) patients., Methods: A cross-sectional survey was performed in 2265 adult CD patients recruited through the Dutch Coeliac Association. Self-reported diet adherence was compared among groups based on self-reported depressive symptoms (categorized into current [1-month], remitted, and never)., Results: The life-time prevalence rate of self-reported depressive symptoms was 39.0% (n=883), of whom 270 (11.9%) suffered from current depressive symptoms. Adherence to gluten-free diet was strict in 50.2% of patients, sufficient in 46.3%, and insufficient in 3.6%. Insufficient adherence was not associated with current depressive symptoms (odds ratio [OR] 0.95; 95% confidence interval [CI]: 0.48-1.92). Keeping a gluten-free diet for longer than five years was associated with lower OR of current depressive symptoms compared to being on a diet for less than two years (OR 0.69; 95% CI: 0.50-0.95)., Conclusions: Lifetime depressive symptoms may be present in one third of the CD patients who adhere to gluten-free diet. Long-term adherence to the gluten-free diet may reduce the risk of current depressive symptoms., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objective: To investigate the feasibility of echographic imaging of healthy and reconstructed cleft lip and to estimate tissue dimensions and normalized echo level., Methods: Echographic images of the upper lip were made on three healthy subjects and two patients using a linear array transducer (7 to 11 MHz bandwidth) and a noncontact gel coupling. Tissue dimensions were measured using calipers. Echo levels were calibrated and were corrected for beam characteristics, gel path, and tissue attenuation using a tissue-mimicking phantom., Results: At the central position of the philtrum, mean thickness (SD) of lip loose connective tissue layer, orbicularis oris muscle, and dense connective layer was 4.0 (0.1) mm, 2.3 (0.7) mm, and 2.2 (0.7) mm, respectively, in healthy lip at rest; and 4.1 (0.9) mm, 3.8 (1.7) mm, and 2.6 (0.6) mm, respectively, in contracted lip. Mean (SD) echo level of muscle and dense connective tissue layer with respect to echo level of lip loose connective tissue layer was -19.3 (0.6) dB and -10.7 (4.0) dB, respectively, in relaxed condition and -20.7 (1.5) dB and -7.7 (2.3) dB, respectively, in contracted state. Color mode echo images were calculated, showing lip tissues in separate colors and highlighting details like discontinuity of the orbicularis oris muscle and presence of scar tissue., Conclusions: Quantitative assessment of thickness and echo level of various lip tissues is feasible after proper echographic equipment calibration. Diagnostic potentials of this method for noninvasive evaluation of cleft lip reconstruction outcome are promising.