1 型糖尿病无症状患者中用于筛查乳糜泻的检测方法的准确性。
Accuracy of Screening Tests for Celiac Disease in Asymptomatic Patients With Type 1 Diabetes.
机构信息
Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
出版信息
Am J Gastroenterol. 2021 Jul 1;116(7):1545-1549. doi: 10.14309/ajg.0000000000001193.
INTRODUCTION
To evaluate the diagnostic performance of celiac serologic tests in asymptomatic patients with type 1 diabetes (T1D).
METHODS
Patients with T1D asymptomatic for celiac disease were prospectively screened with immunoglobulin A anti-tissue transglutaminase. Test characteristics were calculated and optimal cutoffs for a positive screen determined.
RESULTS
Two thousand three hundred fifty-three patients were screened and 101 proceeded to biopsy. The positive predictive value of immunoglobulin A anti-tissue transglutaminase at the assay referenced upper limit of normal (30CU) was 85.9%, and the sensitivity and specificity were 100% and 38%, respectively.
DISCUSSION
Thresholds extrapolated from the general population for the diagnostic evaluation of celiac disease are not suitable for use in asymptomatic T1D patients. Population-specific screening cutoffs are required.
简介
评估 1 型糖尿病（T1D）无症状患者中乳糜泻血清学检测的诊断性能。
方法
前瞻性筛选 T1D 无症状乳糜泻患者，使用 IgA 抗组织转谷氨酰胺酶进行检测。计算检测特性并确定阳性筛查的最佳截断值。
结果
对 2353 例患者进行筛查，101 例进行活检。在参考正常上限（30CU）下，IgA 抗组织转谷氨酰胺酶的阳性预测值为 85.9%，敏感性和特异性分别为 100%和 38%。
讨论
从一般人群中推断出的用于乳糜泻诊断评估的阈值不适合用于无症状 T1D 患者。需要使用特定于人群的筛查截断值。
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