Популяционное исследование распространенности целиакии среди школьников г. Москвы

Abstract

Objective. Examination of schoolchildren in Moscow using a specially designed questionnaire to identify children at risk of developing celiac disease. Patients and methods. The study enrolled 3070 Moscow schoolchildren aged 7–18 years old. Serological and genetic examinations were performed in 42 children at risk for celiac disease, including determination of IgA and IgE to wheat, IgA and IgG to tissue transglutaminase, and IgA to endomysium. Molecular HLA testing for alleles that predispose to celiac disease was conducted. Endoscopic and morphological diagnostics were performed when indicated. Results. The risk group for celiac disease amounted to 10.2% of all schoolchildren surveyed. According to the results of the questionnaire, children in the risk group significantly more often had abdominal pain, excess gas, bloating, flatulence, dyspeptic complaints (diarrhea, constipation, vomiting), asthma attacks or other forms of allergies, headache, joint or body pain, fatigue and weakness, mood swings, depression, anxiety, or episodes of emotional arousal. Changes in height, weight, delayed physical or sexual development, dental enamel defects, and skin rashes were also noted. Of the 42 children in the risk group, the DQ2 heterodimer was detected in 13 (31%) children, the DQ8 heterodimer – in 2 (4.8%), and a combination of DQ2 and DQ8 heterodimers – in 1 (2.4%). Thus, characteristic HLA haplotypes were identified in 38% of the examined children. Three children had IgA antibodies to tissue transglutaminase (at >10 norm) and IgA anti-endomysium antibody titers. Conclusion. The method of questioning by means of a specially designed questionnaire for school-age children allows to identify individuals at risk of developing celiac disease. According to serological, genetic, endoscopic, and morphological investigations, the incidence of celiac disease among children at risk was 7.1%. The prevalence of celiac disease among school-age children in Moscow corresponds to global trends, amounting to 0.7%. Key words: questionnaire, gluten-free diet, cereals, gluten intolerance, celiac disease, children