Assessment of autonomic function in untreated adult coeliac disease

• Published in: World journal of gastroenterology : WJG Vol. 10; no. 18; pp. 2715 - 2718
• Main Authors: Giorgetti, Gian-Marco, Tursi, Antonio, Iani, Cesare, Arciprete, Flavio, Brandimarte, Giovanni, Capria, Ambrogio, Fontana, Luigi
• Format: Journal Article
• Language: English
• Published: United States Department of Internal Medicine, Clinical Nutrition Unit, "S. Eugenio" Hospital, Rome, Italy%Digestive Endoscopy Unit, "Lorenzo Bonomo" Hospital, Andria (BA), Italy%Division of Neurology, "S. Eugenio" Hospital, Rome, Italy%Department of Internal Medicine, Division of Gastroenterology, "Cristo Re" Hospital, Rome, Italy%Department of Internal Medicine and Immunology, "Tor Vergata" University, Rome, Italy 15.09.2004; Baishideng Publishing Group Inc
• Subjects: Adult; Aged; Autonomic Nervous System Diseases - complications; Autonomic Nervous System Diseases - physiopathology; Blood Pressure; Brief Reports; Celiac Disease - complications; Celiac Disease - diet therapy; Celiac Disease - physiopathology; Female; Glutens - administration & dosage; Heart Rate; Humans; Hypotension, Orthostatic - complications; Hypotension, Orthostatic - physiopathology; Male; Middle Aged
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v10.i18.2715

Some recent studies showed that alteration of upper-gut motility in coeliac disease may be related to dysfunction of autonomic nervous system. The aim of our study was to investigate whether autonomic nervous system was altered in untreated and unselected coeliac disease patients. We studied 8 untreated and consecutive coeliac disease patients (2 males and 6 females, age range 37+/-14.5 years). Histological evaluation of duodenal mucosa, anti-gliadin antibodies (AGA), antiendomysial antibodies (EMA) and anti-tTG antibodies and sorbitol H2 breath test were performed in all patients. Extrinsic autonomic neuropathy was assessed by the standardized measurement of cardiovascular reflexes (lying-to-standing, Valsalva manoeuvre, deep breathing, sustained handgrip). The results obtained were compared with a healthy, asymptomatic control group (6 males and 7 females, age range 42.3+/-13.5 years). Coeliac patients exhibited a lower increase of PAS as a response to isometric effort, a reduction of spectral power LF as a response to clinostatic position, but without statistical significance. Also they showed a lower tolerance to orthostatic position, associated with a latent disequilibrium of sympathetic-vagal balance, a relative prevalence of parasympathetic component of the autonomic function. However, these results were not statistically significant when compared with control group (P = n.s.). And they were unchanged after 6 and 12 mo of gluten-free diet. This study failed to confirm a significant correlation between autonomic dysfunction and coeliac disease, yet we could not exclude a role of autonomic dysfunction in the genesis of systemic symptoms in some coeliacs.