Assessment of autonomic function in untreated adult coeliac disease.
OBJECTIVE
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.


METHODS
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).


RESULTS
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.


CONCLUSIONS
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.
Department of Internal Medicine, Clinical Nutrition Unit, S. Eugenio Hospital, Rome, Italy.
Gian-Marco
GM
Giorgetti
Antonio
A
Tursi
Cesare
C
Iani
Flavio
F
Arciprete
Giovanni
G
Brandimarte
Ambrogio
A
Capria
Luigi
L
Fontana
D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000503:physiopathology*; D001794:Blood Pressure; D002446:Celiac Disease / Q000150:complications / Q000178:diet therapy / Q000503:physiopathology*; D005260:Female; D005983:Glutens / Q000008:administration & dosage; D006339:Heart Rate; D006801:Humans; D007024:Hypotension, Orthostatic / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged
D005983:Glutens