Jabeen Shaista, Khan Azmat Ullah, Ahmed Waqas, Ahmad Mansur-Ud-Din, Jafri Saghir Ahmad, Bacha Umar, Ali Amjed, Muzammil Hafiz Shehzad, Alsagaby Suliman A, Al Abdulmonem Waleed, Abdelgawad Mohamed A, Riaz Mishal, Nasir Makia, Zafar Aimen, Tufail Tabussam, Imran Muhammad, Anwar Faridi Tallat, Aslam Maria, Abid Shah Syedda Fatima, Farooq Sana, Awan Tayyaba Niaz, Ur-Rehman Habib
Department of Food Science and Human Nutrition, University of Veterinary and Animal Sciences, Lahore, Pakistan.
Faculty of Allied Health Sciences, University Institute of Diet and Nutritional Sciences, The University of Lahore, Lahore, Pakistan.
Front Nutr. 2022 Sep 7;9:944449. doi: 10.3389/fnut.2022.944449. eCollection 2022.
Celiac disease (CD) was considered a rare disease before and was perceivably only limited to children but now affects almost 1-2% of the global population. This abrupt increase in prevalence is due to advancements in diagnostic criteria and medical facilities but still many countries lack the basic data that can assess the severity of this health issue. The present study was conducted with the aim to assess the common but rarely diagnosed condition with the identification of its underlying secondary ailments.
Patients visiting public sector hospitals were recruited and tested for clinical symptoms secondary to gluten-containing foods (wheat and barley, etc.), followed by serological testing for immunoglobulin A, tissue transglutaminase A, and anti-endomysial antibodies. Only seropositive candidates were included in the endoscopic and biopsy examination for the features of villous atrophy and intestinal cell damage. The secondary ailments including anemia, growth retardation, and gastrointestinal symptoms were also documented for the tested positive patients. The modified European Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) criterion was followed throughout the study.
From 647 suspected cases from March 2018 to July 2019, 113 were confirmed with CD while 58% were female children and 42% were male children. The majority of them were from a lower class (75%) and 26% of them had a positive family history of CD. A total of 67% of patients with CD were underweight while wasting was observed in 38%, and 80% were stunted as well. Of the positively tested patients with CD, 49% had moderate anemia with 15% having severe anemia. Approximately 33% had hypoalbuminemia as well. The majority of them had a mild to severe range of gastrointestinal symptoms, such as abdominal pain, diarrhea, flatus, eructation, diarrhea, and steatorrhea.
The study finding indicates an increased number of patients diagnosed with CD with an excessive sum of secondary ailments, such as anemia, growth failure, growth retardation, malnutrition, and gastrointestinal symptoms.
乳糜泻(CD)以前被认为是一种罕见疾病,且人们普遍认为仅局限于儿童,但现在影响着全球近1%-2%的人口。患病率的这种突然上升归因于诊断标准和医疗设施的进步,但仍有许多国家缺乏能够评估这一健康问题严重程度的基础数据。本研究旨在评估这种常见但很少被诊断出的疾病,并确定其潜在的继发性疾病。
招募到公立医院就诊的患者,检测其食用含麸质食物(小麦和大麦等)后的临床症状,随后进行免疫球蛋白A、组织转谷氨酰胺酶A和抗肌内膜抗体的血清学检测。只有血清学检测呈阳性的候选者才被纳入内镜检查和活检,以检查绒毛萎缩和肠细胞损伤的特征。还记录了检测呈阳性患者的继发性疾病,包括贫血、生长发育迟缓及胃肠道症状。整个研究遵循修改后的欧洲儿科胃肠病学、肝病学和营养学会(ESPGHAN)标准。
在2018年3月至2019年7月的647例疑似病例中,113例确诊为乳糜泻,其中58%为女童,42%为男童。他们中的大多数来自低收入阶层(75%),26%有乳糜泻家族史。共有67%的乳糜泻患者体重过轻,38%出现消瘦,80%发育迟缓。在检测呈阳性的乳糜泻患者中,49%患有中度贫血,15%患有重度贫血。约33%也有低白蛋白血症。他们中的大多数有轻至重度的胃肠道症状,如腹痛、腹泻、肠胃气胀、嗳气、腹泻和脂肪泻。
研究结果表明,被诊断为乳糜泻的患者数量增加,同时伴有大量继发性疾病,如贫血、生长障碍、生长发育迟缓、营养不良和胃肠道症状。