Department of Gastroenterology and Hepatology, Shimane University School of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.
Department of Pathology, Shimane University School of Medicine, Izumo, Japan.
J Gastroenterol. 2018 Feb;53(2):208-214. doi: 10.1007/s00535-017-1339-9. Epub 2017 Apr 7.
Celiac disease is a chronic autoimmune enteropathy caused by gluten ingestion. While its prevalence in Western countries is reported to be as high as 1%, the prevalence has not been evaluated in a large-scale study of a Japanese population. The aim of our study was to clarify the possible presence of celiac disease in a Japanese non-clinical population as well as in patients showing symptoms suggestive of the disease.
Serum samples were collected from 2008 non-clinical adults and 47 patients with chronic unexplained abdominal symptoms between April 2014 and June 2016. The anti-tissue transglutaminase (TTG) immunoglobulin A antibody titer was determined as a screening test for celiac disease in all subjects, and individuals with a value of >2 U/mL subsequently underwent testing for the presence of serum endomysial IgA antibody (EMA) as confirmation. Those testing positive for EMA or with a high concentration (>10 U/mL) of TTG were further investigated by histopathological examinations of duodenal mucosal biopsy specimens and HLA typing tests.
Of the 2008 non-clinical adults from whom serum samples were collected, 161 tested positive for TTG, and all tested negative for EMA. Four subjects who had a high TTG titer were invited to undergo confirmatory testing, and the histopathological results confirmed the presence of celiac disease in only a single case (0.05%). Of the 47 symptomatic patients, one (2.1%) was found to have a high TTG titer and was diagnosed with celiac disease based on duodenal histopathological findings.
The presence of celiac disease in a non-clinical Japanese population was low at 0.05% and was rarely found in patients with unexplained chronic abdominal symptoms.
乳糜泻是一种由麸质摄入引起的慢性自身免疫性肠病。虽然在西方国家的患病率高达 1%，但尚未在日本人群的大规模研究中评估过其患病率。我们的研究旨在阐明乳糜泻在日本非临床人群以及表现出疑似该病症状的患者中的可能存在情况。
2008 年从非临床成年人和 2014 年 4 月至 2016 年 6 月期间的 47 名患有慢性不明原因腹部症状的患者中采集血清样本。所有受试者均进行抗组织转谷氨酰胺酶（TTG）免疫球蛋白 A 抗体滴度测定作为乳糜泻的筛查试验，抗体滴度>2U/mL 的个体随后进行血清内肌内膜 IgA 抗体（EMA）检测以确认。对 EMA 阳性或 TTG 浓度较高（>10U/mL）的个体进行十二指肠黏膜活检组织的组织病理学检查和 HLA 分型检测。
在采集血清样本的 2008 名非临床成年人中，有 161 名 TTG 阳性，且所有 EMA 均为阴性。4 名 TTG 滴度较高的个体受邀进行确认性检测，仅 1 例（0.05%）的组织病理学结果证实存在乳糜泻。在 47 名有症状的患者中，1 名（2.1%）患者 TTG 滴度较高，根据十二指肠组织病理学发现诊断为乳糜泻。
非临床日本人群中乳糜泻的患病率较低（0.05%），在不明原因慢性腹部症状患者中很少发现。
