Nội dung được dịch bởi AI, chỉ mang tính chất tham khảo
Tỷ lệ bệnh Celiac ở bệnh nhân bị triệu chứng khó tiêu: Một Tổng quan có hệ thống và Phân tích tổng hợp
Tóm tắt
Bệnh nhân mắc bệnh Celiac (CeD) thường có dấu hiệu triệu chứng khó tiêu. Chúng tôi đã tiến hành một cuộc tổng quan có hệ thống và phân tích tổng hợp các tài liệu hiện có nhằm đánh giá tỷ lệ mắc CeD ở những bệnh nhân được chẩn đoán mắc triệu chứng khó tiêu. Chúng tôi đã tìm kiếm trong các cơ sở dữ liệu MEDLINE và EMBASE với các từ khóa: bệnh Celiac, bệnh coeliac, kháng thể chống gliadin, kháng thể transglutaminase mô, kháng thể chống nội mô, triệu chứng khó tiêu và rối loạn tiêu hóa chức năng. Tất cả các nghiên cứu được công bố từ tháng 1 năm 1991 đến tháng 5 năm 2021 đã được đưa vào. Chẩn đoán CeD dựa trên các hướng dẫn của Hiệp hội Tiêu hóa Nhi khoa châu Âu. Mô hình ngẫu nhiên đã được sử dụng để tổng hợp dữ liệu. Hai mươi mốt nghiên cứu đã sàng lọc 10.275 bệnh nhân bị triệu chứng khó tiêu được đưa vào tổng quan. Tỷ lệ huyết thanh mắc CeD, dựa trên kháng thể transglutaminase mô và/hoặc kháng thể chống nội mô dương tính là 4,8% (95% CI [2,8, 6,7%], I2 = 87,7%). Tỷ lệ CeD xác nhận bằng sinh thiết là 1,5% (95% CI [1,0, 1,9%]; I2 = 59,8%) ở những bệnh nhân này. Cả tỷ lệ huyết thanh (Tỷ lệ Odds: 1,8; 95% CI [0,8, 4,0%]; I2 = 0%) và tỷ lệ CeD xác nhận bằng sinh thiết (Tỷ lệ Odds: 1,4; 95% CI [0,8, 2,4]; I2 = 0%) không cao hơn ở bệnh nhân bị triệu chứng khó tiêu so với nhóm chứng. Có một nguy cơ trung bình về định kiến lựa chọn và sự dị biệt đáng kể trong các kết quả tổng hợp. Tỷ lệ mắc CeD tổng hợp trong các bệnh nhân mắc triệu chứng khó tiêu là 1,5% và không cao hơn đáng kể so với dân số nói chung. Các kết quả này không hỗ trợ việc sàng lọc bệnh nhân bị triệu chứng khó tiêu cho bệnh CeD.
Từ khóa
#bệnh Celiac #triệu chứng khó tiêu #tỷ lệ huyết thanh #sinh thiết #phân tích tổng hợp #tổng quan có hệ thốngTài liệu tham khảo
citation_journal_title=Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc.; citation_title=Global prevalence of celiac disease: systematic review and meta-analysis; citation_author=P Singh, A Arora, TA Strand, DA Leffler, C Catassi, PH Green; citation_volume=16; citation_issue=6; citation_publication_date=2018; citation_pages=823-836.e2; citation_id=CR1
citation_journal_title=Nutrients.; citation_title=Extra-intestinal manifestation of celiac disease in children; citation_author=H Jericho, S Guandalini; citation_volume=10; citation_issue=6; citation_publication_date=2018; citation_pages=755; citation_doi=10.3390/nu10060755; citation_id=CR2
Singh AD, Singh P, Farooqui N, Strand T, Ahuja V, Makharia GK. Prevalence of celiac disease in patients with short stature: A systematic review and Meta-analysis. J Gastroenterol Hepatol. 2020 Jul 3;
US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, Barry MJ, Davidson KW, et al. Screening for celiac disease: US preventive services task force recommendation statement. JAMA. 2017;317(12):1252–7.
citation_journal_title=JAMA Intern Med.; citation_title=Celiac Disease and Nonceliac Gluten or Wheat Sensitivity: The Risks and Benefits of Diagnosis; citation_author=NJ Talley, MM Walker; citation_volume=177; citation_issue=5; citation_publication_date=2017; citation_pages=615-616; citation_doi=10.1001/jamainternmed.2017.0695; citation_id=CR5
citation_journal_title=Gut.; citation_title=Global prevalence of, and risk factors for, uninvestigated dyspepsia: a meta-analysis; citation_author=AC Ford, A Marwaha, R Sood, P Moayyedi; citation_volume=64; citation_issue=7; citation_publication_date=2015; citation_pages=1049-1057; citation_doi=10.1136/gutjnl-2014-307843; citation_id=CR6
citation_journal_title=World J Gastroenterol.; citation_title=Epidemiology of functional dyspepsia: a global perspective; citation_author=S Mahadeva, K-L Goh; citation_volume=12; citation_issue=17; citation_publication_date=2006; citation_pages=2661-2666; citation_doi=10.3748/wjg.v12.i17.2661; citation_id=CR7
citation_journal_title=N Engl J Med.; citation_title=Functional dyspepsia; citation_author=NJ Talley, AC Ford; citation_volume=373; citation_issue=19; citation_publication_date=2015; citation_pages=1853-1863; citation_doi=10.1056/NEJMra1501505; citation_id=CR8
citation_journal_title=Am J Gastroenterol.; citation_title=ACG and CAG clinical guideline: management of dyspepsia; citation_author=P Moayyedi, BE Lacy, CN Andrews, RA Enns, CW Howden, N Vakil; citation_volume=112; citation_issue=7; citation_publication_date=2017; citation_pages=988-1013; citation_doi=10.1038/ajg.2017.154; citation_id=CR9
citation_journal_title=Aliment Pharmacol Ther.; citation_title=Meta-analysis: yield of diagnostic tests for coeliac disease in dyspepsia; citation_author=AC Ford, E Ching, P Moayyedi; citation_volume=30; citation_issue=1; citation_publication_date=2009; citation_pages=28-36; citation_doi=10.1111/j.1365-2036.2009.04008.x; citation_id=CR10
citation_journal_title=J Pediatr Gastroenterol Nutr.; citation_title=Increased prevalence of abdominal pain-functional gastrointestinal disorders in pediatric celiac patients despite a strict gluten free diet; citation_author=F Cristofori, V Bentivoglio, LC Raguseo, ME Tripaldi, A Gentile, P Giordano; citation_volume=66; citation_issue=Supplement 2; citation_publication_date=2018; citation_pages=415; citation_id=CR11
citation_journal_title=J Paediatr Child Health.; citation_title=Yield of coeliac screening in abdominal pain-associated functional gastrointestinal system disorders; citation_author=A Kansu, Z Kulotlu, A Demir, A Yaman; citation_volume=51; citation_issue=11; citation_publication_date=2015; citation_pages=1066-1070; citation_doi=10.1111/jpc.12929; citation_id=CR12
citation_journal_title=Gastroenterol Res Pract.; citation_title=The prevalence of occult celiac disease among patients with functional dyspepsia: a study from the western region of Iran; citation_author=AA Keshavarz, H Bashiri, A Ahmadi, S Bazargan-Hejazi; citation_volume=2010; citation_issue=101475557; citation_publication_date=2010; citation_pages=170702; citation_id=CR13
citation_journal_title=Arq Gastroenterol.; citation_title=Celiac disease prevalence is not increased in patients with functional dyspepsia; citation_author=J Lasa, L Spallone, S Gandara, E Chaar, S Berman, D Zagalsky; citation_volume=54; citation_issue=1; citation_publication_date=2017; citation_pages=37-40; citation_doi=10.1590/s0004-2803.2017v54n1-07; citation_id=CR14
Majeed AAA, Shaalan HK, Hussein BA, Homadi S. Prevalence of Celiac Disease in Dyspeptic Patients. Karbala J. Med. 2017;10(3):3833–3840.
citation_journal_title=Gastroenterol Hepatol Bed Bench.; citation_title=Gluten associated dyspepsia; serology and histological characteristics; citation_author=M Rostami Nejad, R Dabiri, MJ Ehsani-Ardakani, E Nazemalhosseini Mojarad, F Derakhshan, M Telkabadi; citation_volume=5; citation_issue=4; citation_publication_date=2012; citation_pages=197-201; citation_id=CR16
citation_journal_title=J Dig Dis.; citation_title=Prevalence of celiac disease in Indian patients with irritable bowel syndrome and uninvestigated dyspepsia; citation_author=H Sharma, AK Verma, P Das, S Dattagupta, V Ahuja, GK Makharia; citation_volume=16; citation_issue=8; citation_publication_date=2015; citation_pages=443-448; citation_doi=10.1111/1751-2980.12260; citation_id=CR17
citation_journal_title=J Pediatr Gastroenterol Nutr.; citation_title=European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease; citation_author=S Husby, S Koletzko, IR Korponay-Szabó, ML Mearin, A Phillips, R Shamir; citation_volume=54; citation_issue=1; citation_publication_date=2012; citation_pages=136-160; citation_doi=10.1097/MPG.0b013e31821a23d0; citation_id=CR18
citation_journal_title=BMJ.; citation_title=PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement; citation_author=D Moher, A Liberati, J Tetzlaff, DG Altman; citation_volume=339; citation_publication_date=2009; citation_pages=b2535; citation_doi=10.1136/bmj.b2535; citation_id=CR19
Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. [Internet]. [cited 2019 Jan 18]. Available from:
http://handbook.cochrane.org
citation_journal_title=J Clin Epidemiol.; citation_title=Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement; citation_author=D Hoy, P Brooks, A Woolf, F Blyth, L March, C Bain; citation_volume=65; citation_issue=9; citation_publication_date=2012; citation_pages=934-939; citation_doi=10.1016/j.jclinepi.2011.11.014; citation_id=CR21
Deeks JJ, Higgins JPT, Altman DG. 9.5.2 Identifying and measuring heterogeneity [Internet]. [cited 2019 Sep 3]. Available from:
https://handbook-5-1.cochrane.org/chapter_9/9_5_2_identifying_and_measuring_heterogeneity.htm
citation_journal_title=Turk J Gastroenterol.; citation_title=Prevalence of celiac disease among dyspeptic patients: A community-based case-control study; citation_author=E Altintas, MS Senli, O Sezgin; citation_volume=19; citation_issue=2; citation_publication_date=2008; citation_pages=81-84; citation_id=CR23
citation_journal_title=Arch Intern Med.; citation_title=Increased prevalence of celiac disease in patients with dyspepsia; citation_author=MT Bardella, G Minoli, D Ravizza, F Radaelli, P Velio, M Quatrini; citation_volume=160; citation_issue=10; citation_publication_date=2000; citation_pages=1489-1491; citation_doi=10.1001/archinte.160.10.1489; citation_id=CR24
citation_journal_title=Gastrointest Endosc.; citation_title=Reliability of the “immersion technique” during routine upper endoscopy for detection of abnormalities of duodenal villi in patients with dyspepsia; citation_author=G Cammarota, GA Pirozzi, A Martino, G Zuccala, R Cianci, L Cuoco; citation_volume=60; citation_issue=2; citation_publication_date=2004; citation_pages=223-228; citation_doi=10.1016/S0016-5107(04)01553-6; citation_id=CR25
citation_journal_title=QJM Mon J Assoc Physicians.; citation_title=The hunt for coeliac disease in primary care; citation_author=P Collin, M Rasmussen, S Kyronpalo, P Laippala, K Kaukinen; citation_volume=95; citation_issue=2; citation_publication_date=2002; citation_pages=75-77; citation_doi=10.1093/qjmed/95.2.75; citation_id=CR26
citation_journal_title=Arch Intern Med.; citation_title=Accuracy of ultrasonography in predicting celiac disease; citation_author=M Fraquelli, A Colli, A Colucci, MT Bardella, C Trovato, R Pometta; citation_volume=164; citation_issue=2; citation_publication_date=2004; citation_pages=169-174; citation_doi=10.1001/archinte.164.2.169; citation_id=CR27
citation_journal_title=J Clin Gastroenterol.; citation_title=Are routine duodenal and antral biopsies useful in the management of “functional” dyspepsia? A diagnostic and therapeutic study; citation_author=M Frazzoni, A Lonardo, A Grisendi, G Della Casa, M Pulvirenti, AM Ferrari; citation_volume=17; citation_issue=2; citation_publication_date=1993; citation_pages=101-108; citation_doi=10.1097/00004836-199309000-00004; citation_id=CR28
citation_journal_title=World J Gastroenterol.; citation_title=Prevalence of celiac disease in adult patients with refractory functional dyspepsia: value of routine duodenal biopsy; citation_author=E Giangreco, C D’agate, C Barbera, L Puzzo, G Aprile, P Naso; citation_volume=14; citation_issue=45; citation_publication_date=2008; citation_pages=6948-6953; citation_doi=10.3748/wjg.14.6948; citation_id=CR29
citation_journal_title=World J Gastroenterol.; citation_title=A Brazilian experience of the self transglutaminase-based test for celiac disease case finding and diet monitoring; citation_author=LM Silva Kotze, APB Rodrigues, LR Kotze, RM Nisihara; citation_volume=15; citation_issue=35; citation_publication_date=2009; citation_pages=4423-4428; citation_doi=10.3748/wjg.15.4423; citation_id=CR30
citation_journal_title=Endoscopy.; citation_title=Endoscopic markers of villous atrophy are not useful for the detection of celiac disease in patients with dyspeptic symptoms; citation_author=S Lecleire, F Fiore, M Antonietti, G Savoye, F Lemoine, F Pessot; citation_volume=38; citation_issue=7; citation_publication_date=2006; citation_pages=696-701; citation_doi=10.1055/s-2006-925373; citation_id=CR31
citation_journal_title=Arq Gastroenterol.; citation_title=Prevalence of celiac disease in dyspeptic patients; citation_author=VM Lima, L Gandolfi, JA Pires, R Pratesi; citation_volume=42; citation_issue=3; citation_publication_date=2005; citation_pages=153-156; citation_doi=10.1590/S0004-28032005000300005; citation_id=CR32
citation_journal_title=Mayo Clin Proc.; citation_title=Celiac disease serology in irritable bowel syndrome and dyspepsia: a population-based case-control study; citation_author=GR Locke, JA Murray, AR Zinsmeister, LJ Melton, NJ Talley; citation_volume=79; citation_issue=4; citation_publication_date=2004; citation_pages=476-482; citation_doi=10.4065/79.4.476; citation_id=CR33
citation_journal_title=Dig Dis Sci.; citation_title=Prevalence of silent celiac disease in patients with dyspepsia; citation_author=E Ozaslan, S Akkorlu, E Eskioglu, B Kayhan; citation_volume=52; citation_issue=3; citation_publication_date=2007; citation_pages=692-697; citation_doi=10.1007/s10620-006-9453-1; citation_id=CR34
Vivas S, Ruiz de Morales JM, Martinez J, Gonzalez MC, Martin S, Martin J, et al. Human recombinant anti-transglutaminase antibody testing is useful in the diagnosis of silent coeliac disease in a selected group of at-risk patients. Eur J Gastroenterol Hepatol. 2003;15(5):479–83.
Behforouz A, Faravani E, Esmaeelzadeh A, Mozaffari HM, Mokhtarifar A, Goshayeshi L, et al. Routine Multiple Duodenal Biopsy during Endoscopy of Dyspeptic Patients Seems Unnecessary for Screening of Celiac Disease. Gastroenterol Res Pract. 2020;2020((Behforouz, Faravani) Radiology Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of):6664741.
citation_journal_title=J Clin Gastroenterol.; citation_title=The, “Epigastric Distress Syndrome”: A possible disease entity identified by history and endoscopy in patients with nonulcer dyspepsia; citation_author=O Nyrén, H-O Adami, S Gustavsson, PG Lindgren, L Lööf, A Nyberg; citation_volume=9; citation_issue=3; citation_publication_date=1987; citation_pages=303-309; citation_doi=10.1097/00004836-198706000-00012; citation_id=CR37
citation_journal_title=Scand J Prim Health Care.; citation_title=Endomysium antibodies are superior to gliadin antibodies in screening for coeliac disease in patients presenting supposed functional gastrointestinal symptoms; citation_author=L Agreus, K Svardsudd, G Tibblin, B Lavo; citation_volume=18; citation_issue=2; citation_publication_date=2000; citation_pages=105-110; citation_doi=10.1080/028134300750018990; citation_id=CR38
Incarbone S, Aprile G, Puzzo L, Bonanno G, Naso P, D', et al. Bioptic evaluation of duodenal mucosa in adult dyspeptic patients (PTS): High prevalence of celiac disease (CD). A prospective study. Dig Liver Dis [Internet]. [cited 2020 Aug 15];38. Available from:
https://www.academia.edu/29391489/Bioptic_evaluation_of_duodenal_mucosa_in_adult_dyspeptic_patients_PTS_High_prevalence_of_celiac_disease_CD_A_prospective_study
citation_journal_title=Scand J Gastroenterol.; citation_title=Etiology of dyspepsia: four hundred unselected consecutive patients in general practice; citation_author=M Heikkinen, P Pikkarainen, J Takala, H Räsänen, R Julkunen; citation_volume=30; citation_issue=6; citation_publication_date=1995; citation_pages=519-523; citation_doi=10.3109/00365529509089783; citation_id=CR40
citation_journal_title=Endoscopy.; citation_title=Is there a case for routine duodenal biopsy at gastroscopy or is a targeted approach adequate?; citation_author=AD Hopper, TS Chew, A Lewis, DS Sanders; citation_volume=40; citation_issue=9; citation_publication_date=2008; citation_pages=727-730; citation_doi=10.1055/s-2008-1077361; citation_id=CR41
Magazzu G, Bottari M, Tuccari G, Arco A, Pallio S, Lucanto C, et al. Upper gastrointestinal endoscopy can be a reliable screening tool for celiac sprue in adults. J Clin Gastroenterol. 1994 Oct;19(3):255–7; discussion 257–258.
citation_journal_title=Nat Rev Gastroenterol Hepatol.; citation_title=Functional dyspepsia–symptoms, definitions and validity of the Rome III criteria; citation_author=J Tack, NJ Talley; citation_volume=10; citation_issue=3; citation_publication_date=2013; citation_pages=134-141; citation_doi=10.1038/nrgastro.2013.14; citation_id=CR43
citation_journal_title=J Pediatr Gastroenterol Nutr.; citation_title=Rome II versus Rome III classification of functional gastrointestinal disorders in pediatric chronic abdominal pain; citation_author=KF Baber, J Anderson, M Puzanovova, LS Walker; citation_volume=47; citation_issue=3; citation_publication_date=2008; citation_pages=299-302; citation_doi=10.1097/MPG.0b013e31816c4372; citation_id=CR44
citation_journal_title=Off J Am Coll Gastroenterol ACG.; citation_title=Mass screening for celiac disease: the autoimmunity screening for kids study; citation_author=MG Stahl, C Geno Rasmussen, F Dong, K Waugh, JM Norris, J Baxter; citation_volume=116; citation_issue=1; citation_publication_date=2021; citation_pages=180-187; citation_doi=10.14309/ajg.0000000000000751; citation_id=CR45
citation_journal_title=Am J Gastroenterol.; citation_title=“ASKing” the right questions about screening for celiac disease; citation_author=GM Forbes; citation_volume=116; citation_issue=1; citation_publication_date=2021; citation_pages=82-83; citation_doi=10.14309/ajg.0000000000001026; citation_id=CR46
citation_journal_title=Nat Rev Dis Primer.; citation_title=Functional dyspepsia; citation_author=P Enck, F Azpiroz, G Boeckxstaens, S Elsenbruch, C Feinle-Bisset, G Holtmann; citation_volume=3; citation_issue=1; citation_publication_date=2017; citation_pages=17081; citation_doi=10.1038/nrdp.2017.81; citation_id=CR47
Singh P, Singh A, Silvester JA, Sachdeva V, Chen X, Xu H, et al. Inter- and intra-assay variation in the diagnostic performance of assays for anti-tissue transglutaminase in 2 populations. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2019;18(11):2628–2630.
citation_journal_title=Am J Gastroenterol.; citation_title=A report on the international transglutaminase autoantibody workshop for celiac disease; citation_author=M Li, L Yu, C Tiberti, M Bonamico, I Taki, D Miao; citation_volume=104; citation_issue=1; citation_publication_date=2009; citation_pages=154-163; citation_doi=10.1038/ajg.2008.8; citation_id=CR49
citation_journal_title=Gastroenterology.; citation_title=Epidemiology, presentation, and diagnosis of celiac disease; citation_author=B Lebwohl, A Rubio-Tapia; citation_volume=160; citation_issue=1; citation_publication_date=2021; citation_pages=63-75; citation_doi=10.1053/j.gastro.2020.06.098; citation_id=CR50
The best research databases for healthcare and medicine [Update 2019] [Internet]. Paperpile. [cited 2020 Dec 25]. Available from:
https://paperpile.com/g/research-databases-healthcare/