Du Yang, Shan Ling-Fei, Cao Zong-Ze, Feng Jin-Chao, Cheng Yong
Center on Translational Neuroscience, College of Life and Environmental Sciences, Minzu University of China, Beijing 100081, China.
Oncotarget. 2017 Dec 23;9(4):5387-5396. doi: 10.18632/oncotarget.23624. eCollection 2018 Jan 12.
The association between Down syndrome and celiac disease has been reported by many studies. However, the prevalence of celiac disease (CD) in Down syndrome (DS) varies considerably across studies (from 0 % to 19 %). The aim of this study was to use meta-analysis to exam the prevalence of CD in patients with DS.
A systematic search of English articles from Pubmed, Web of Science and CNKI without year limitation. Data were extracted by two independent observers and pooled using a random effects model by the Comprehensive Meta-Analysis Version 2 software.
A pooled analysis, based on 31 studies included 4383 individuals, revealed prevalence of biopsy-confirmed CD of 5.8 % (95 % CI = 4.7-7.2 %) in patients with DS. Sub-group analysis showed a slightly higher prevalence of CD in children with DS (6.6 %; 17 studies), than in age mixed samples with both children and adults (5.1 %; 13 studies). In addition, most of the studies included in this meta-analysis were from Europe and America, with the prevalence of celiac disease of 6 % (21 studies) and 5.7 % (6 studies) in DS patients, respectively. Furthermore, meta-regression analysis suggested that proportion of antibody-positive individuals that underwent small intestine biopsy had moderating effect on the outcome of the meta-analysis.
These results demonstrated that patients (children) with Down syndrome had high prevalence of CD (more than one in twenty). The prevalence is high enough to motivate screening CD in DS children.
许多研究报道了唐氏综合征与乳糜泻之间的关联。然而，唐氏综合征（DS）患者中乳糜泻（CD）的患病率在不同研究中差异很大（从0%到19%）。本研究的目的是通过荟萃分析来检验DS患者中CD的患病率。
对来自PubMed、科学网和中国知网的英文文章进行无年份限制的系统检索。由两名独立观察者提取数据，并使用综合荟萃分析2软件的随机效应模型进行汇总。
基于31项研究（共4383名个体）的汇总分析显示，DS患者中经活检确诊的CD患病率为5.8%（95%置信区间=4.7-7.2%）。亚组分析显示，DS儿童中CD的患病率（6.6%；17项研究）略高于儿童和成人混合年龄样本（5.1%；13项研究）。此外，本荟萃分析中的大多数研究来自欧美，DS患者中乳糜泻的患病率分别为6%（21项研究）和5.7%（6项研究）。此外，荟萃回归分析表明，接受小肠活检的抗体阳性个体比例对荟萃分析结果有调节作用。
这些结果表明，唐氏综合征患者（儿童）中CD的患病率很高（超过二十分之一）。该患病率高到足以促使对DS儿童进行CD筛查。
