伊朗肠易激综合征患者中乳糜泻的患病率：一项横断面研究。

Prevalence of celiac disease in Iranian patients with irritable bowel syndrome: a cross-sectional study.

作者信息

Shayesteh Ali Akbar, Hajiani Eskandar, Hashemi Seyed Jalal, Masjedizadeh Abdolrahim, Latifi Seyed Mahmod, Shayesteh Mehdi

机构信息

Research Institute for Infectious Diseases of Digestive System, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

J Dig Dis. 2014 Jan;15(1):12-7. doi: 10.1111/1751-2980.12102.

DOI:10.1111/1751-2980.12102

PMID:24320042

Abstract

OBJECTIVE

This study was aimed to determine the prevalence of celiac disease (CD) in irritable bowel syndrome (IBS) and its subtypes in a group of Iranian patients.

METHODS

From March 2007 to June 2009, 465 consecutive patients who were referred to the gastroenterology clinic of Jundishapur University of Medical Sciences and fulfilled the Rome III criteria for IBS were included. Immunoglobulin A (IgA) anti-tissue transglutaminase (IgA-tTG) and anti-gliadin antibody (AGA) levels were measured. CD was confirmed by gastroduodenoscopy and biopsy in patients with abnormal antibodies.

RESULTS

Five patients had only elevated IgA-tTG, 26 with only elevated AGA, and in 16 patients abnormal results for both antibodies were reported. Duodenal biopsies from these 47 patients confirmed CD in 13 (2.8%, 95% CI 1.6-4.0%) according to the Marsh criteria. Two CD patients had normal IgA-tTG concentrations while only one patient with normal AGA was proven to have CD. CD was most prevalent in unsubtyped IBS (4.9%, 95% CI 1.1-8.7%), followed by mixed IBS (4.7%, 95% CI 0.3-9.1%). In multiple comparison, CD was less common in diarrhea-predominant IBS than in unsubtyped IBS, although this did not reach statistical significance (1.0% vs. 4.9%, P = 0.057).

CONCLUSIONS

CD in unsubtyped IBS had a growing trend to be more common than in diarrhea-predominant IBS. Evaluation of IBS patients for CD is advisable.

摘要

目的

本研究旨在确定一组伊朗患者中肠易激综合征（IBS）及其亚型中乳糜泻（CD）的患病率。

方法

2007年3月至2009年6月，纳入465例连续转诊至赞詹医科大学胃肠病诊所且符合IBS罗马III标准的患者。检测免疫球蛋白A（IgA）抗组织转谷氨酰胺酶（IgA-tTG）和抗麦醇溶蛋白抗体（AGA）水平。抗体异常的患者通过胃十二指肠镜检查和活检确诊CD。

结果

5例患者仅IgA-tTG升高，26例仅AGA升高，16例患者两种抗体结果均异常。根据马什标准，这47例患者的十二指肠活检确诊13例CD（2.8%，95%可信区间1.6 - 4.0%）。2例CD患者IgA-tTG浓度正常，而仅1例AGA正常的患者被证实患有CD。CD在未分型IBS中最常见（4.9%，95%可信区间1.1 - 8.7%），其次是混合型IBS（4.7%，95%可信区间0.3 - 9.1%）。在多重比较中，腹泻型IBS中的CD比未分型IBS少见，尽管未达到统计学显著性（1.0%对4.9%，P = 0.057）。