拉脱维亚功能性胃肠疾病患者中乳糜泻的患病率较低。

Low Prevalence of Celiac Disease among Patients with Functional Gastrointestinal Disorders in Latvia.

机构信息

Faculty of Medicine, University of Latvia, Riga, Latvia.

Faculty of Medicine, University of Latvia, Riga, Latvia; Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia.

出版信息

J Gastrointestin Liver Dis. 2020 Mar 13;29(1):33-39. doi: 10.15403/jgld-233.

DOI:10.15403/jgld-233

PMID:32176757

Abstract

BACKGROUND AND AIMS

Studies suggest that the prevalence of celiac disease (CD) is increased in individuals with functional gastrointestinal disorders (FGIDs), in particular, irritable bowel syndrome (IBS); however, the evidence is conflicting. We aimed to analyze the prevalence of CD in patients with FGIDs in Latvia.

METHODS

This retrospective study included patients with FGIDs, referred for a gastroenterologist consultation in a secondary gastroenterology practice unit. Patients were divided into three groups - patients only with IBS (IBS group), patients only with functional dyspepsia (FD) (FD group), patients with mixed symptoms IBS and FD (Mixed group). Patient levels of tissue transglutaminase IgA (tTG-IgA) and/or antiendomysial IgA group antibodies (EMA-IgA) were evaluated. Four duodenal biopsies were obtained and reported according to Marsh classification. Patients diagnosed or being referred for confirmation of CD were excluded from the study.

RESULTS

Overall, 1,833 FGIDs patients were enrolled. Celiac serology was available for 1,570 patients, duodenal histology for 582 patients, both histology and serology for 319 patients. In total, celiac seropositivity was present in 1.78% (28/1570) (3.18% in IBS group, 0.90% in FD group and 1.11% of cases in the mixed group). Fifteen patients had histopathological changes (2.58%; 15/582). Three IBS patients (2.36%) were both serology and biopsy positive. None of the FD patients had CD.

CONCLUSION

Prevalence of biopsy-proven CD in patients from Latvia with FGIDs was low. Routine screening for CD could be considered only among patients with IBS.

摘要

背景与目的

研究表明，在功能性胃肠疾病（FGIDs）患者中，尤其是在肠易激综合征（IBS）患者中，乳糜泻（CD）的患病率增加；然而，证据存在矛盾。我们旨在分析拉脱维亚 FGIDs 患者中 CD 的患病率。

方法

本回顾性研究纳入了在二级胃肠病学实践单位就诊的 FGIDs 患者。患者被分为三组 - 仅患有 IBS 的患者（IBS 组）、仅患有功能性消化不良（FD）的患者（FD 组）和同时患有 IBS 和 FD 混合症状的患者（混合组）。评估患者的组织转谷氨酰胺酶 IgA（tTG-IgA）和/或抗内肌层 IgA 抗体（EMA-IgA）水平。根据 Marsh 分类获取并报告了 4 个十二指肠活检结果。患有 CD 或被转介以确认 CD 的患者被排除在研究之外。

结果

总体而言，共有 1833 名 FGIDs 患者入组。1570 名患者的乳糜泻血清学结果可用，582 名患者的十二指肠组织学结果可用，319 名患者的血清学和组织学结果均可用。总的来说，乳糜泻血清学阳性率为 1.78%（28/1570）（IBS 组为 3.18%，FD 组为 0.90%，混合组为 1.11%）。15 名患者的组织病理学有变化（2.58%；582 例中有 15 例）。3 名 IBS 患者（2.36%）血清学和活检均为阳性。FD 患者均无 CD。