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原发性胆汁性胆管炎患者中乳糜泻的患病率。

Prevalence of Celiac Disease in Patients with Primary Biliary Cholangitis.

作者信息

Callichurn Kashi, Cvetkovic Lena, Therrien Amélie, Vincent Catherine, Hétu Pierre-Olivier, Bouin Mickael

机构信息

Division of Gastroenterology, Centre Hospitalier de l'Université de Montréal (CHUM), CRCHUM, Montreal, Quebec, Canada.

出版信息

J Can Assoc Gastroenterol. 2020 Jan 2;4(1):44-47. doi: 10.1093/jcag/gwz039. eCollection 2021 Feb.

DOI:10.1093/jcag/gwz039
PMID:33644676
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7898370/
Abstract

BACKGROUND

Primary biliary cholangitis (PBC) frequently coexists with other autoimmune diseases, including celiac disease (CeD). Although the prevalence of CeD is high among cohorts with PBC, few studies have directly compared this prevalence to those among individuals with other liver diseases (OLD).

AIM

To compare the prevalence of CeD between a cohort with PBC and a cohort with OLD.

METHODS

Retrospective study from January 2013 to December 2016. All consecutive patients with an anti-transglutaminase (tTG) assay requested by a hepatologist and a diagnosis of chronic liver disease were included. CeD diagnosis was confirmed by duodenal biopsies.

RESULTS

We included 399 consecutive patients (53.1 years SD 14.0, 54.1% women), notably 51 individuals with PBC and 348 individuals with OLD. PBC group included significantly more women (90.2% versus 48.9% < 0.0001). The prevalence of CeD was higher in the group with PBC compared to the group with OLD (11.8 versus 2.9%, < 0.003). In the OLD group, the prevalence of CeD was comparable regardless of the etiologic subgroup (nonalcoholic steatohepatitis 2.7% versus alcoholic liver disease 4.3%, versus viral 1.5% versus other autoimmune liver diseases 3.3%, NS). The presence of gastrointestinal symptoms at the time of the tTG assay was comparable between PBC and OLD groups (31.4 versus 29.6%, NS).

CONCLUSION

There is a higher prevalence of CeD in the PBC group compared to other liver diseases.

摘要

背景

原发性胆汁性胆管炎(PBC)常与其他自身免疫性疾病共存,包括乳糜泻(CeD)。尽管CeD在PBC队列中的患病率较高,但很少有研究将此患病率与其他肝病(OLD)个体的患病率进行直接比较。

目的

比较PBC队列和OLD队列中CeD的患病率。

方法

回顾性研究,时间跨度为2013年1月至2016年12月。纳入所有肝病专家要求进行抗转谷氨酰胺酶(tTG)检测且诊断为慢性肝病的连续患者。CeD诊断通过十二指肠活检确诊。

结果

我们纳入了399例连续患者(平均年龄53.1岁,标准差14.0,女性占54.1%),其中51例为PBC患者,348例为OLD患者。PBC组女性明显更多(90.2%对48.9%,<0.0001)。与OLD组相比,PBC组中CeD的患病率更高(11.8%对2.9%,<0.003)。在OLD组中,无论病因亚组如何,CeD的患病率相当(非酒精性脂肪性肝炎2.7%对酒精性肝病4.3%,对病毒性肝病1.5%,对其他自身免疫性肝病3.3%,无显著性差异)。tTG检测时胃肠道症状的出现情况在PBC组和OLD组之间相当(31.4%对29.6%,无显著性差异)。

结论

与其他肝病相比,PBC组中CeD的患病率更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3a4/7898370/07fc39de33a9/gwz039f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3a4/7898370/07fc39de33a9/gwz039f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3a4/7898370/07fc39de33a9/gwz039f0001.jpg

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Clin Liver Dis. 2018 Aug;22(3):429-441. doi: 10.1016/j.cld.2018.03.001.
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Global Prevalence of Celiac Disease: Systematic Review and Meta-analysis.全球乳糜泻患病率:系统评价和荟萃分析。
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EASL Clinical Practice Guidelines: The diagnosis and management of patients with primary biliary cholangitis.EASL 临床实践指南:原发性胆汁性胆管炎患者的诊断和管理。
J Hepatol. 2017 Jul;67(1):145-172. doi: 10.1016/j.jhep.2017.03.022. Epub 2017 Apr 18.
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Reovirus infection triggers inflammatory responses to dietary antigens and development of celiac disease.呼肠孤病毒感染引发对饮食抗原的炎症反应和乳糜泻的发展。
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