Kıyak M, Düzenli T, İbrahim A
Health Science University, Faculty of Medicine, Department of Gastroenterology, Istanbul, Turkey.
Hitit University, Faculty of Me-dicine, Department of Gastroenterology, Çorum, Turkey.
Clin Ter. 2025;173(3):310-316. doi: 10.7417/CT.2025.5227.
This study aimed to determine the efficacy of the De Ritis ratio, which is cheaper and easily accessible compared to celiac antibodies, in the diagnosis of celiac disease and in predicting dietary compliance in follow-up.
MATERIAL AND METHODS.: 152 patients over 18 years of age who were diagnosed with celiac disease during a 4-year period in the gastroenterology department of a tertiary care regional hospital and 237 patients without celiac disease as control group were included. Endoscopy and pathology results, laboratory values and pre-diagnostic De Ritis ratios of both groups were compared. Patients with celiac disease were divided into 2 groups as diet-compliant and diet-incompliant. Laboratory values and De Ritis ratios of these 2 groups at diagnosis and at the end of the first year were compared.
There were 152 patients in the celiac group and 237 patients in the control group. AST (p<0.001) and AST/ALT mean value (p<0.001) were higher in the celiac patient group compared to the control group. AST/ALT ratio at the time of diagnosis was similar to the AST/ALT ratio at the end of first year in the diet non-compliant group, but the difference between them was not statistically significant (p=0.945). However, AST/ALT ratio at the end of the first year in diet-compliant celiac patient group was lower than at the time of diagnosis (1.17; 1.02, p<0.001).
De Ritis ratio may be a promising inexpensive, simple and easily accessible candidate to help clinicians differentiate Celiac disease and assess disease activity and dietary adherence.
本研究旨在确定与乳糜泻抗体相比更便宜且易于获取的德瑞蒂斯比值（De Ritis ratio）在乳糜泻诊断及随访中预测饮食依从性方面的疗效。
纳入一家三级区域医院胃肠病科在4年期间诊断为乳糜泻的152例18岁以上患者，并将237例无乳糜泻的患者作为对照组。比较两组的内镜检查和病理结果、实验室值及诊断前的德瑞蒂斯比值。将乳糜泻患者分为饮食依从组和饮食不依从组。比较这两组在诊断时及第一年末的实验室值和德瑞蒂斯比值。
乳糜泻组有152例患者，对照组有237例患者。与对照组相比，乳糜泻患者组的AST（p<0.001）和AST/ALT平均值（p<0.001）更高。在饮食不依从组中，诊断时的AST/ALT比值与第一年末的AST/ALT比值相似，但两者之间的差异无统计学意义（p=0.945）。然而，饮食依从的乳糜泻患者组在第一年末的AST/ALT比值低于诊断时（1.17；1.02，p<0.001）。
德瑞蒂斯比值可能是一种有前景的、廉价、简单且易于获取的指标，有助于临床医生鉴别乳糜泻并评估疾病活动度和饮食依从性。
