Department of Epidemiology, School of Public Health & Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran.
BMC Gastroenterol. 2024 Oct 9;24(1):357. doi: 10.1186/s12876-024-03446-x.
This study aimed to estimate the prevalence of obesity, overweight, and underweight in celiac disease (CD) at diagnosis before starting the Gluten-free diet (GFD).
A comprehensive search was conducted in PubMed, Embase, Scopus, and Web of Science until July 2024 to find the cross-sectional and longitudinal studies that measured the body mass index (BMI) in CD patients at diagnosis. The risk of bias assessment was conducted using the Newcastle-Ottawa Quality Assessment scale. Meta-regression analyses were applied to understand whether weight status is associated with CD.
A total of 23 studies involving 15,299 CD patients and 815,167 healthy individuals were included in this study. In newly diagnosed CD patients, pooled estimates of the prevalence of obesity, overweight, and underweight before GFD were 11.78%, 18.42%, and 11.04%, respectively. The prevalence of overweight and obesity in newly diagnosed CD patients increased from 22.15% in 2003-2009 to 32.51% in 2016-2021. Meta-regression analyses indicated that the CD patients with higher BMI had a higher mean age (p = 0.001), and female gender had a marginally significant (p = 0.055) association with higher BMI. Only a few CD patients were underweight at the time of diagnosis, and more patients were overweight/obese.
our meta-analysis demonstrated that only a few CD patients were underweight at the time of diagnosis, and almost 37% were overweight or obese. Meta-regression showed a significant association between higher BMI and higher mean age and female gender. A delay or failure for diagnosis of CD is more common in overweight/obese patients, resulting in more progression of the disease and counteracting any advantages of diagnosis.
本研究旨在评估在开始无麸质饮食（GFD）之前诊断为乳糜泻（CD）时肥胖、超重和体重不足的患病率。
对 PubMed、Embase、Scopus 和 Web of Science 进行全面检索，以查找截至 2024 年 7 月测量 CD 患者诊断时体重指数（BMI）的横断面和纵向研究。使用纽卡斯尔-渥太华质量评估量表进行偏倚风险评估。应用荟萃回归分析来了解体重状况是否与 CD 相关。
本研究共纳入 23 项研究，涉及 15299 名 CD 患者和 815167 名健康个体。在新诊断的 CD 患者中，GFD 前肥胖、超重和体重不足的患病率分别为 11.78%、18.42%和 11.04%。新诊断的 CD 患者中超重和肥胖的患病率从 2003-2009 年的 22.15%增加到 2016-2021 年的 32.51%。荟萃回归分析表明，BMI 较高的 CD 患者年龄较大（p=0.001），女性性别与较高 BMI 呈边缘显著相关（p=0.055）。只有少数 CD 患者在诊断时体重不足，而更多的患者超重/肥胖。
我们的荟萃分析表明，只有少数 CD 患者在诊断时体重不足，而近 37%的患者超重或肥胖。荟萃回归显示，BMI 较高与平均年龄较高和女性性别之间存在显著关联。CD 的诊断延迟或失败在超重/肥胖患者中更为常见，导致疾病进展更多，抵消了诊断的任何优势。
