Locke G Richard, Murray Joseph A, Zinsmeister Alan R, Melton L Joseph, Talley Nicholas J
Division of Gastroenterology and Hepatology and Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA.
Mayo Clin Proc. 2004 Apr;79(4):476-82. doi: 10.4065/79.4.476.
To determine whether undiagnosed celiac disease is associated with irritable bowel syndrome (IBS) or dyspepsia in the community.
A self-report bowel disease questionnaire was mailed to a random sample of Olmsted County, Minnesota, residents aged 20 to 50 years. All respondents who reported symptoms of dyspepsia or IBS (cases) and all respondents without notable gastrointestinal symptoms (controls) were invited to participate (260 eligible subjects; 150 [58%] were studied). Each respondent was examined by a physician, and the medical records of each were reviewed (3 subjects did not meet the criteria for dyspepsia or IBS at the time of the physician interview). Serum was obtained to measure antiendomysial antibodies and tissue transglutaminase (TTg) IgA antibodies using validated assays.
A total of 34 subjects had dyspepsia (20 had ulcerlike dyspepsia), 50 had IBS (19 had diarrhea-predominant IBS), and 15 met criteria for both dyspepsia and IBS; 78 were asymptomatic healthy controls. The overall prevalence of positive TTg serology was 4% (95% confidence interval [CI], 1.5%-8.5%). The number of subjects who were seropositive for TTg was 2 of 34 (5.9%) with dyspepsia (95% CI, 0.7%-19.7%), 2 of 50 (4.0%) with IBS (95% CI, 0.5%-13.7%), and 2 of 78 (2.6%) of asymptomatic controls (95% CI, 03%-9.0%) (P = .64 IBS vs controls; P = .58 dyspepsia vs controls). No subjects had positive antiendomysial antibodies.
In this community, celiac disease did not explain the presence of either IBS or dyspepsia.
确定社区中未确诊的乳糜泻是否与肠易激综合征（IBS）或消化不良相关。
向明尼苏达州奥尔姆斯特德县年龄在20至50岁的居民随机抽样邮寄一份肠道疾病自填问卷。所有报告有消化不良或IBS症状的受访者（病例组）以及所有无明显胃肠道症状的受访者（对照组）均受邀参与研究（260名符合条件的受试者；150名[58%]接受了研究）。每位受访者均接受医生检查，并查阅其病历（3名受试者在医生问诊时不符合消化不良或IBS的标准）。采用经过验证的检测方法获取血清以检测抗肌内膜抗体和组织转谷氨酰胺酶（TTg）IgA抗体。
共有34名受试者患有消化不良（20名患有溃疡样消化不良），50名患有IBS（19名以腹泻为主的IBS），15名同时符合消化不良和IBS的标准；78名是无症状的健康对照者。TTg血清学检测阳性的总体患病率为4%（95%置信区间[CI]，1.5% - 8.5%）。TTg血清学检测呈阳性的受试者数量在患有消化不良的34名受试者中有2名（5.9%）（95% CI，0.7% - 19.7%），在患有IBS的50名受试者中有2名（4.0%）（95% CI，0.5% - 13.7%），在无症状对照者的78名受试者中有2名（2.6%）（95% CI，0.3% - 9.0%）（IBS与对照组相比，P = 0.64；消化不良与对照组相比，P = 0.58）。没有受试者抗肌内膜抗体呈阳性。
在这个社区中，乳糜泻并不能解释IBS或消化不良的存在。
