Division of Epidemiology and Public Health, University of Nottingham, Queens Medical Centre, Nottingham, UK.
Aliment Pharmacol Ther. 2010 Jan;31(1):73-81. doi: 10.1111/j.1365-2036.2009.04110.x.
Following the appreciation of the importance of gliadin deamidation in the immunopathogenesis of coeliac disease, diagnostic tests based on antibodies to deamidated gliadin peptides have been developed and shown to have high sensitivity and specificity.
To compare the performance of the deamidated gliadin peptides antibody test with the current standard, the tissue transglutaminase antibody test, through a meta-analysis of published studies.
Databases from 1998 to 2008 were searched for relevant studies. These were assessed for methodological quality and standard statistical tests were applied to compare particularly the sensitivity and specificity of the two tests for the diagnosis of coeliac disease.
Most studies had methodological flaws, especially ascertainment bias. The pooled sensitivities for the deamidated gliadin peptides antibody and tissue transglutaminase antibody tests were 87.8% (95% CI, 85.6-89.9) and 93.0% (95% CI, 91.2-94.5) respectively and the pooled specificities were 94.1% (95% CI, 92.5-95.5) and 96.5% (95% CI, 95.2-97.5) respectively.
Although both tests perform well, the tissue transglutaminase antibody test outperforms the deamidated gliadin peptides antibody test and remains the preferred serological test for the diagnosis and/or exclusion of coeliac disease.
在认识到麦胶蛋白脱酰胺在乳糜泻发病机制中的重要性之后，已经开发出了基于脱酰胺麦胶蛋白肽的抗体的诊断检测方法，并已证实这些方法具有很高的灵敏度和特异性。
通过对已发表的研究进行荟萃分析，比较脱酰胺麦胶蛋白肽抗体检测与目前的标准——组织转谷氨酰胺酶抗体检测的性能。
检索了 1998 年至 2008 年的数据库，以寻找相关的研究。对这些研究进行了方法学质量评估，并应用了标准的统计检验，特别是比较了两种检测方法在乳糜泻诊断中的灵敏度和特异性。
大多数研究存在方法学缺陷，尤其是确定偏倚。脱酰胺麦胶蛋白肽抗体和组织转谷氨酰胺酶抗体检测的汇总灵敏度分别为 87.8%（95%CI，85.6-89.9）和 93.0%（95%CI，91.2-94.5），汇总特异性分别为 94.1%（95%CI，92.5-95.5）和 96.5%（95%CI，95.2-97.5）。
尽管两种检测方法都表现良好，但组织转谷氨酰胺酶抗体检测优于脱酰胺麦胶蛋白肽抗体检测，仍然是乳糜泻诊断和/或排除的首选血清学检测方法。
