Azami Milad, Badfar Gholamreza, Abangah Ghobad, Mahmoudi Leily
Medical Student, Student Research Committee, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
Assistant Professor, Department of Pediatrics, Behbahan School of Medicine, Ahvaz jundishapour university of Medical science, Behbahan, Iran.
Gastroenterol Hepatol Bed Bench. 2019 Spring;12(2):85-97.
The present study was conducted to evaluate the prevalence, clinical symptoms and pathological findings of celiac disease (CD) in irritable bowel syndrome (IBS) patients in Iran.
Several studies show high prevalence of CD in IBS patients, but the results are contradictory.
The present study was conducted based on MOOSE protocol and results were reported according to PRISMA guideline. The search was done using international online databases (Scopus, PubMed, Science Direct, Cochrane Library, Embase, and Web of Science), national databases and Google Scholar search engine.
The pooled prevalence of CD in 2,367 Iranian IBS patients was estimated to be 6.13% (95%CI: 4.11-9.05). The prevalence of CD in men and women with IBS was 4.28% (95% CI: 2.45-7.37) and 7.19% (95% CI: 4.51-11.28), respectively. The serological prevalence of anti tTG-IgA (11 studies with 2901 IBS patients) and AGA-IgG (4 studies with 936 IBS patients) was estimated to be 5.35% (95%CI: 3.60-7.89) and 6.35% (95%CI: 2.05-18.03), respectively. The clinical symptoms of CD among IBS patients included predominant diarrhea (47.87% [95%CI: 22.46-74.43]), predominant constipation (17.34% [95%CI: 9.17-30.35]), and alternative diarrhea and constipation (27.84% [95%CI: 11.57-53.23]). According to pathological findings based on marsh classification, the prevalence of CD at stages 1, 2 and 3 were 30.89% (95%CI: 13.25-56.68), 36.56% (95%CI: 21.74-54.45) and 52.87% (95%CI: 14.48-88.13), respectively.
In the present meta-analysis, we observed a high prevalence for CD among Iranian IBS patients, which is higher than global estimates. Examination of all IBS patients in terms of CD seems to be necessary, but cost-effectiveness should be considered
本研究旨在评估伊朗肠易激综合征（IBS）患者中乳糜泻（CD）的患病率、临床症状及病理结果。
多项研究表明IBS患者中CD患病率较高，但结果相互矛盾。
本研究依据MOOSE协议开展，并按照PRISMA指南报告结果。通过国际在线数据库（Scopus、PubMed、Science Direct、Cochrane图书馆、Embase及Web of Science）、国家数据库及谷歌学术搜索引擎进行检索。
2367例伊朗IBS患者中CD的合并患病率估计为6.13%（95%置信区间：4.11 - 9.05）。IBS男性和女性患者中CD的患病率分别为4.28%（95%置信区间：2.45 - 7.37）和7.19%（95%置信区间：4.51 - 11.28）。抗组织转谷氨酰胺酶IgA（11项研究，共2901例IBS患者）和抗麦胶蛋白IgG（4项研究，共936例IBS患者）的血清学患病率估计分别为5.35%（95%置信区间：3.60 - 7.89）和6.35%（95%置信区间：2.05 - 18.03）。IBS患者中CD的临床症状包括以腹泻为主（47.87% [95%置信区间：22.46 - 74.43]）、以便秘为主（17.34% [95%置信区间：9.17 - 30.35]）以及腹泻与便秘交替出现（27.84% [95%置信区间：11.57 - 53.23]）。根据基于马什分类的病理结果，1期、2期和3期CD的患病率分别为30.89%（95%置信区间：13.25 - 56.68）、36.56%（95%置信区间：21.74 - 54.45）和52.87%（95%置信区间：14.48 - 88.13）。
在本荟萃分析中，我们观察到伊朗IBS患者中CD患病率较高，高于全球估计值。对所有IBS患者进行CD检查似乎有必要，但应考虑成本效益。
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