Prevalence Of Celiac Disease In Patients Research Articles

Celiac disease prevalence in patients with idiopathic inflammatory myopathies, a cross-sectional study.

Up to 30% of patients with celiac disease (CD) suffer from concurrent autoimmune disease, compared to 3% of the general population. The association between CD and the current clinical phenotypes of inflammatory myopathies (IIM) patients has not been thoroughly addressed. Assess the CD features among patients with IIM and their relationship with the clinical phenotype and the myositis specific (MSA) and associated antibodies (MAA). For this cross-sectional study, we recruited 99 adult patients classified as IIM from a tertiary center in Mexico. We assessed serum MSA, MAA, and CD-associated autoantibodies (IgA anti-tissue transglutaminase (tTG) and both IgA and IgG anti-deaminated gliadin peptide (DGP)). Patients with highly suggestive serology for CD were then tested for IgG anti-endomysium antibodies, and a duodenal biopsy was performed. 70.7% of patients were positive for at least one antibody. Nine duodenal biopsies were taken, revealing findings compatible with celiac disease in two cases. Subjects with anti-MDA5 antibodies were more likely to have positive anti-tTG IgA antibodies (OR 6.76, 95% CI 1.85-24.62, P = 0.013) and suggestive CD serology (OR 6.41, 95% CI 1.62-25.29, P = 0.009). Patients with anti-Mi2 antibodies were more likely to have positive anti-DGP IgG antibodies (OR 3.35, 95% CI 1.12-9.96, P = 0.039), while positivity for these autoantibodies was less frequent in patients with anti-NXP2 antibodies (OR 0.22, 95% CI 0.06-0.80, P = 0.035). There is a higher prevalence of serologic and definite CD in patients with IIM compared to the general population. Identifying this subgroup of patients may have prognostic and therapeutic implications. Key points • The study estimated a serological celiac disease (CD) prevalence of 70.7% in patients with idiopathic inflammatory myopathies (IIM) and a biopsy-confirmed prevalence of 2%, suggesting that IIM patients should be considered a high-risk population for CD. • We identified a significant association between serological CD and the presence of anti-MDA5 and anti-Mi2 antibodies, suggesting a potential justification for celiac disease screening in this specific subgroup of patients. • The impact of gluten-free diets on IIM patients with serological markers of CD remains untested and warrants further investigation through prospective, randomized studies.

Liver and celiac disease. Review

Celiac hepatitis is a gluten‑dependent liver disease that usually eliminates after 12 months of a strict gluten‑free diet. What is important is that liver histology also improves after a gluten‑free diet. Hypertransaminasemia (in 13—60% of cases) is common at the untreated celiac disease (CD). Conversely, CD presents in 9% of patients with unexplained hypertransaminasemia. Patients with CD have a higher risk of both subsequent liver disease and death caused by cirrhosis compared to the general population. Pathogenetic mechanisms underlying CD, have not been sufficiently studied. The permeability of the intestinal mucosa appears to be considerably higher in patients with CD and hypertransaminasemia than in patients with CD and normal liver tests. The normalization of intestinal permeability and transaminase levels after following a gluten‑free diet demonstrates that this phenomenon is gluten‑dependent. It has been suggested that increased intestinal permeability promotes the admission of toxins, microbial and other antigens, cytokines, and/or other mediators of liver damage into the portal circulation (and hence to the liver). However, liver damage is not usually observed in other intestinal pathologies associated with increased intestinal permeability. A liver biopsy is rarely performed in celiac hepatitis. Mild and/or non‑specific histological changes are observed. Severe liver fibrosis and cirrhosis occur rarely.
 Primary biliary cholangitis and autoimmune hepatitis may be associated with CD. The incidence of CD in patients with primary biliary cholangitis is 1—7%, while the incidence of primary biliary cholangitis in patients with CD is 0.1—3%. CD is revealed in 4—6% of patients with autoimmune hepatitis, both type 1 and type 2. Cases of primary sclerosing cholangitis combined with CD have been reported, too.
 No correlation has been found between CD and chronic hepatitis C. Treatment of hepatitis C with interferon‑a and/or ribavirin may activate occult or latent CD. The incidence of CD in patients with non‑alcoholic fatty liver disease ranges from 3% to 7%.
 The prevalence of CD in patients after liver transplantation for a variety of reasons ranges from 3% to 4.3%.
 Liver‑caused mortality is increased in patients with CD, although the absolute risk of mortality from liver failure is low.

Prevalence of Celiac Disease in Patients With Liver Diseases: A Systematic Review and Meta-Analyses.

A subset of patients with celiac disease (CeD) has liver involvement in the form of hypertransaminasemia, liver cirrhosis, and autoimmune hepatitis. We conducted a systematic review with meta-analyses to determine the pooled prevalence of CeD in patients with cryptogenic cirrhosis, all-cause cirrhosis, cryptogenic hypertransaminasemia, and all-cause hypertransaminasemia. We searched PubMed and EMBASE up to January 2022. Cross-sectional, case-control, and prospective cohort studies performing serological tests and/or intestinal biopsy for CeD on patients with cryptogenic cirrhosis, all-cause cirrhosis, cryptogenic hypertransaminasemia, and all-cause hypertransaminasemia were included to calculate pooled estimates of seroprevalence and the prevalence of biopsy-confirmed CeD in these 4 groups. Of 6,871 articles screened, 20 articles were included finally in 3 meta-analyses for cryptogenic cirrhosis, all-cause cirrhosis, and cryptogenic hypertransaminasemia. For the all-cause hypertransaminasemia group, a qualitative review of 4 studies was conducted instead of a meta-analysis due to significant differences in studies. The pooled prevalence (95% confidence interval) of biopsy-confirmed CeD in cryptogenic cirrhosis was 4.6% (2.2%-7.5%) while the pooled prevalence of biopsy-confirmed CeD in all-cause cirrhosis was 0.8% (0%-3.4%). The pooled prevalence of biopsy-confirmed CeD in cryptogenic hypertransaminasemia was 5.7% (3.2%-8.8%). Nearly 1 in 20 patients each with cryptogenic cirrhosis and cryptogenic hypertransaminasemia have CeD; hence, they should both be considered high-risk groups for CeD. While the prevalence of CeD in those with all-cause cirrhosis is similar to that in general population, it may be worth screening them for CeD because liver pathology has the potential for reversal in them.

Celiac Disease Frequency Is Increased in IgE-Mediated Food Allergy and Could Affect Allergy Severity and Resolution.

An increased frequency of celiac disease (CeD) has been reported in severe Immunoglobulin E (IgE) -mediated food allergy (FA). This observation requires confirmation, and whether CeD affects FA severity and resolution is unknown. The study aims to estimate the prevalence of CeD in patients with FA and to investigate whether CeD affects FA severity and oral tolerance. Consecutive patients with FA referred for allergen reintroduction, either to evaluate allergy resolution or to start oral immunotherapy (OIT), were evaluated for CeD and for FA severity. The primary outcome was the prevalence of CeD. Secondary outcomes were the frequency of severe FA and the level of clinical tolerance at study entry and at last follow-up in patients with isolated FA versus patients with FA + CeD. Two hundred twenty-eight patients were included. CeD was confirmed in 15 patients (6.6%) of whom, 8 patients had a previously established diagnosis of CeD and were on a gluten-free diet. Severe FA was observed in 12 patients with FA + CeD (80%) versus 88 patients with FA (42%) ( P = 0.006). At baseline, patients with FA + CeD had significantly higher median allergen-specific IgE levels [61.8 kU/L; interquartile range (IQR) 11.6-279.0] compared to patients with FA (20.3 kU/L; IQR 2.9-72.7) ( P < 0.001). Complete clinical tolerance was observed in 1 of 15 patients (7%) with FA + CeD versus 98 of 205 patients (48%) with FA ( P = 0.002). CeD is highly prevalent in patients with FA and could affect FA severity and response to OIT. CeD screening should be considered in patients with severe or persistent FA.

Bi-directional Relationship Between Celiac Disease and Liver Chemistries: A Systematic Review and Meta-Analysis.

Previous studies have reported conflicting results regarding prevalence of elevated LC (2-70%) in celiac disease (CD). This systematic review and meta-analysis assessed the prevalence of elevated LC at time of CD diagnosis and associated response to GFD. We also report the prevalence of CD in patients with unexplained elevation of LC. Studies assessing LC (aspartate aminotransferase [AST] and alanine aminotransferase [ALT]) in CD patients were eligible. Studies with < 50 cases or in pediatric populations were excluded. In total, 20 studies assessing prevalence of elevated LC in 4,265 participants with newly diagnosed CD (mean age = 35.6 ± 6.5years, 69.8% female) were included. Pooled prevalence of elevated LC was 18.7% (95% CI 13.8-24.8; I2 = 95%). Normalization of elevated LC was seen in 83.1% (95% CI 73.4-89.7; I2 = 79%, 11 studies) of patients after GFD. On meta-regression, age at CD diagnosis, gender, and Marsh grading were not associated with elevated LC. Among 979 participants (7 studies) with unexplained elevation of LC, pooled seroprevalence and biopsy-proven CD was 6.4% (95% CI 2.9-10.3, I2 = 71%) and 4.5% (95% CI 2.6-7.7, I2 = 67%), respectively. Elevated LC are seen in approximately one-fifth of patients at CD diagnosis with majority normalizing after GFD. Age, gender, and degree of intestinal damage are not predictive of elevated LC. In the appropriate clinical scenario, liver tests should be serially monitored in CD reserving workup for additional causes after a trial of GFD. Patients with unexplained elevation of liver tests should be screened for celiac disease.

Evaluation of Celiac Disease Prevalence in Patients with ADHD (Attention Deficite/ Hyperactivity Disorder)

Background: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common behavioral disorders among children that has a significant impact on family and society. Recently since numerous cases of ADHD alongside celiac disease and improvement of behavioral symptoms of children with ADHD with gluten-free diet have been proposed, this study was conducted to determine the prevalence of celiac disease in children with ADHD based on serological findings in Sistan.&#x0D; Methods: The present study was performed on 76 children with a diagnosis of ADHD referred to the pediatric clinic of Amir Al-Momenin Hospital in Zabol. Demographic, clinical and paraclinical information such as age, sex and celiac laboratory diagnostic tests (anti-TTG and total IgA) were collected and the results were entered in the information form of each child and analyzed.&#x0D; Results: Among the 76 children participating in this study, 58 were male (76.3%) and the age range of patients was 12-2 years (6.9 ± 2.4). The results of the study showed that based on the results of celiac serology tests performed among children with ADHD, no cases of celiac disease were found. In this study, 26 children (34.21%) have anemia. However, the mean of anti-TTG and total IgA in children with anemia and children without anemia were not statistically significant (p value &gt; 0.05).&#x0D; Conclusion: The results of the present study showed that based on serological findings, no cases of celiac disease were observed among children with ADHD.

Celiac Disease in Juvenile Idiopathic Arthritis and Other Pediatric Rheumatic Disorders.

Celiac Disease (CD) is an immune-mediated and gluten-related disorder whose prevalence is higher in children affected with other autoimmune disorders, including diabetes mellitus type 1, autoimmune thyroiditis, and others. As regards Juvenile Idiopathic Arthritis (JIA) and other pediatric rheumatic disorders, there is no clear recommendation for CD serological screening. In this review, we analyze all the available clinical studies investigating CD among children with JIA (and other rheumatic diseases), in order to provide objective data to better understand the necessity of CD serological screening during the follow-up. Based on the present literature review and analysis, >2.5% patients with JIA were diagnosed with CD; however, the CD prevalence in JIA patients may be even higher (>3–3.5%) due to several study limitations that could have underestimated CD diagnosis to a variable extent. Therefore, serological screening for CD in children affected with JIA could be recommended due to the increased CD prevalence in these patients (compared to the general pediatric population), and because these JIA patients diagnosed with CD were mostly asymptomatic. However, further research is needed to establish a cost-effective approach in terms of CD screening frequency and modalities during the follow-up for JIA patients. Conversely, at the moment, there is no evidence supporting a periodical CD screening in children affected with other rheumatic diseases (including pediatric systemic lupus erythematosus, juvenile dermatomyositis, and systemic sclerosis).

Prevalence of celiac disease in adults with cryptogenic liver disease: an interim analysis

Background and Aim: Celiac Disease (CeD) is a multisystemic disease and in addition to the small intestine, multiple other organs such as skin, liver, and brain are also affected. The spectrum of involvement of liver in CeD includes hypertransaminasemia, cirrhosis of liver and autoimmune liver diseases. There is a lack of data on prevalence of CeD in patients with cryptogenic liver diseases.

Prevalence of celiac disease in patients with type 1 diabetes: a systematic review and meta-analysis

Background. Celiac disease (CD) is more prevalent among type 1 diabetes (T1D) patients compared to the general population and can be accompanied by hypoglycemia episodes in T1D patients. Studies worldwide have reported CD prevalence with large variability. This study aimed to estimate the pooled prevalence of CD in T1D patients. Methods. PubMed, Web of Science, Science Direct, and Scopus were searched without time limitation using the keywords: Celiac Disease, Gluten Enteropathy, Gluten- Sensitive Enteropathy, Wheat Hypersensitivity, Tissue Transglutaminase Antibody, Endomysial Antibody Disease, Diabetes Mellitus, and IDDM. Random-effects inverse variance-weighted model, subgroup analysis, and meta-regression were implemented. Heterogeneity was examined using Cochran’s Q test and I2 statistics. Results. A pooled analysis of 55 articles with total sample size 71,853 revealed that the CD prevalence in patients with T1D was 5.08% (95% CI: 4.44%, 5.73%) with large heterogeneity (I2 = 84%). To account for publication bias, using trim-and-fill method, the pooled prevalence was 4.0% (95% CI: 3.38%, 4.73%). The prevalence of CD was higher in Asia (6.53%, 95% CI: 4.89%, 8.16%) compared to USA (4.89%, 95% CI: 3.85%, 5.93%) and Europe (4.76%, 95% CI: 3.78%, 5.74%). In addition, studies conducted after 2008 reported pooled prevalence (6.37%, 95% CI: 5.25%, 7.49%) significantly higher than those conducted before 2008 (4.14%, 95% CI: 3.19%, 5.09%). Studies with quality score 10 had significantly higher prevalence (7.0%, 95% CI: 5.04%, 8.96%) compared with quality score 7 (3.66%, 95% CI: 2.61%, 4.70%). Conclusion. CD is highly prevalent in T1D patients. Studies from Asia, those published after the year 2008, and studies with quality score 10 had higher pooled CD prevalence. Therefore, early screening for CD in T1D patients is important to prevent complications of CD.

Celiac Disease Prevalence in Patients with Chronic Noninflammatory Diarrhea in 2017

Introduction: Celiac disease is an autoimmune disorder. Eating gluten, which is part of the cereals, can lead to intestinal mucosal injury and diarrhea. Although celiac disease is more common today with non-digestive symptoms, we sometimes encounter cases of chronic non-inflammatory diarrhea, which is one of the clinical manifestations of celiac disease. This study was performed to evaluate the prevalence of celiac disease in patients with chronic non-inflammatory diarrhea. Because diarrhea in celiac disease has distinct and efficient treatment we decided to do this study to evaluate the prevalence of celiac disease in patients with chronic non-inflammatory diarrhea. Methods: This was a descriptive cross sectional study on 200 patients with chronic non-inflammatory diarrhea in Yazd in 2017. Stool exam and tissue transglutaminase Antibody (TTG Ab) was done for the patients; upper endoscopy and duodenum biopsy was done for the patients with high serum TTG Ab. Findings analyzed in SPSS.ver.17 statistical software. Chi-Square, t-test and Fisher Exact tests were used for statistical analysis. P-value less than 0.05 was considered significant. Results: Two hundred patients, including 93 (46.5%) men and 107 women (53.5%) participated in this study. The average age was 34.32 ± 17.84 years. Among these cases, 31 patients (15.5%) had celiac disease. Among cases of celiac (16.1%), 15 (16.1%) were male and 16 (15%) were female. The relative frequency of celiac disease was the same in both sexes and in all age groups. Conclusion: Significant portion of patients (15.5%) with chronic non-inflammatory diarrhea has celiac disease.

Prevalence of celiac disease in patients with atypical presentations

Background and study aimsUnawareness about atypical forms of celiac disease (CD) leads to the underdiagnoses of CD. This study has investigated the prevalence of CD in patients with atypical presentations, such as idiopathic low bone mineral density (ILBMD) and dyspepsia, in the Iranian population. Patients and methodsTwo separate groups of patients who have been diagnosed with dyspepsia and ILBMD (including either osteopenia or osteoporosis of unknown cause) were screened for CD during 2016–2019. Patients were serologically screened by means of IgA anti-tissue transglutaminase (IgA anti-tTG); in case of positive results, the patients underwent endoscopic intestinal biopsy to confirm the diagnosis of CD. ResultsOf 200 patients with ILBMD, six (3%) had a positive result for IgA anti-tTG; in five cases (2.5%), duodenal histology confirmed the CD diagnosis. Of 290 patients with dyspepsia, 25 (8.6%) had a positive result for anti-tTG IgA; nine cases (3.7%) were histologically compatible with CD. No significant differences were found between the two groups of patients. ConclusionsThe prevalence of CD in patients with atypical presentations, such as ILBMD and dyspepsia, is consistent (pvalue = 0.788) and higher than that in the general population (p value = 0.001); therefore, screening program for CD in these patients is highly recommended.

The Prevalence of the Celiac Disease in Patients with Dyspepsia: A Systematic Review and Meta-Analysis.

Patients with celiac disease (CeD) can commonly present with symptoms of dyspepsia. We conducted a systematic review and meta-analysis of the present literature to assess the prevalence of CeD in patients diagnosed with dyspepsia. We searched MEDLINE and EMBASE databases for the keywords: celiac disease, coeliac disease, anti-gliadin, tissue transglutaminase antibody, anti-endomysial antibody, dyspepsia and functional gastrointestinal disorder. All the studies published from January 1991 till May 2021 were included. Diagnosis of CeD was based on the European Society of Pediatric Gastroenterology, Hepatology and Nutrition guidelines. A random-effects model was used to pool the data. Twenty-one studies screening 10,275 patients with dyspepsia were included. The pooled seroprevalence of CeD based on a positive anti-tissue transglutaminase antibody and/or anti-endomysial antibody was 4.8% (95% CI [2.8, 6.7%], I2 = 87.7%). The pooled biopsy-confirmed CeD prevalence was 1.5% (95% CI [1.0, 1.9%]; I2 = 59.8%) in these patients. Both seroprevalence (Odds ratio: 1.8; 95% CI [0.8, 4.0%]; I2 = 0%) and prevalence of biopsy-confirmed CeD (Odds ratio: 1.4; 95% CI [0.8, 2.4]; I2 = 0%) were not higher in patients with dyspepsia compared to controls. There was a moderate risk of selection bias and significant heterogeneity in the pooled results. The pooled prevalence of CeD in patients with dyspepsia was 1.5% and it was not significantly higher than the general population. These results do not support screening of patients with dyspepsia for CeD.

The prevalence of celiac disease in Saudi patients with type 1 diabetes mellitus.

BACKGROUND: Celiac disease (CD) is an autoimmune disease that is highly associated with type 1 diabetes mellitus (T1DM). The reported prevalence of CD in patients with T1DM in Saudi Arabia varies and the number of studies is limited.OBJECTIVES: Determine the prevalence of CD diagnosed with anti-tissue transglutaminase (anti-tTG) antibodies or by endoscopic biopsy in adolescents and adults with T1DM.DESIGN: Cross-sectional, retrospective medical record review.SETTING: Tertiary care center.PATIENTS AND METHODS: The study population included adolescents and adults with T1DM who were screened for CD between 2010 and 2019. The study variables included age, sex, age at diagnosis of T1DM, age of positive celiac screening, glycated hemoglobin (HbA1c), total daily insulin dose, frequency of diabetic ketoacidosis (DKA) and other autoimmune diseases.MAIN OUTCOME MEASURES: The prevalence of celiac disease in adolescents and adults with T1DM.SAMPLE SIZE: 539 patients.RESULTS: The prevalence of positive celiac test results was 11.5% (n=62). A small proportion (n=5, 8%) of the positive CD group was diagnosed with T1DM after they tested positive with the celiac screening test. Ten (16%) were diagnosed with T1DM and CD in the same year. The rest of the sample had a positive screening test after being diagnosed with T1DM. There was no statistically significant difference between the CD positive and negative groups for HbA1C, DKA frequency, microvascular complications of diabetes or thyroid disorder. For histopathological confirmation of CD, only 37% (n=23) of the group with a positive screening test underwent endoscopy. In this group, 43% (n=10) had normal endoscopic biopsy findings, 21.7% (n=5) had partial villous atrophy and 34.7% (n=8) had total villous atrophy.CONCLUSIONS: This study highlights the importance of screening for CD in T1DM patients. CD prevalence is high in patients with T1DM, despite the high likelihood of underdiagnosis. Additional studies of different age groups and the use of different study methods are required. In addition, a unified national strategy to diagnose CD in T1DM patients is highly advisable.LIMITATIONS: Retrospective, single-center, few confirmations of CD by intestinal biopsy.CONFLICT OF INTEREST: None.

Prevalence of celiac disease in irritable bowel syndrome patients: A single centre experience from a large teaching hospital of Lahore, Pakistan

Background: Many studies have been conducted worldwide to evaluate the proportion of patients with Celiac disease (CD) in persons presenting with Irritable Bowel Syndrome (IBS), showing a positive association between the two diseases. However, reports from Pakistan remain scanty. This study aims to find out the prevalence of CD in patients presenting with IBS and to establish the correlation of both diseases.&#x0D; Patients and methods: It was a descriptive cross-sectional study conducted at Combined Military Hospital, Lahore (CMHL) from January 2018 till March 2019. Consecutive, nonprobability sampling was used to include 210 patients of both genders with the age range of 15-65 years fulfilling ROME IV criteria and were not previously diagnosed as CD or CKD or CLD. Demographic data was noted. Serum Anti tTG levels and Duodenal Biopsy from the second part was assessed to diagnose CD. CD was labeled if the disease was present on both serological and Histopathological reports. Data were analyzed by using SPSS version 20. Descriptive statistics were calculated and a Chi-square test was used to compare the outcome variables with P-value &lt; 0.05 as significant.&#x0D; Results: Of 210 enrolled patients, 113 (53, 8%) were male and 97 (46.2%) were female. The mean age of the patients was 28.40 ± 5.06 years. Eight patients (3.8%) were positive for Anti tTg and on histopathological findings suggestive of CD. Seven of 8 were less than 35 years old. Out of 8 positive patients, 6 (75%) were females. However, the p-value was found to be insignificant for age (0.549) and gender (0.096). On stratification with respect to duration of IBS, all 8 patients diagnosed with celiac disease were having symptoms of IBS for less than 12 months (100%) which was significant statistically (7.1% vs 0.0%; p=0.007).&#x0D; Conclusion: The frequency of CD was 3.8% among IBS patients. Considering this percentage of CD in IBS patients s, a high index of suspicion for CD in IBS patients is required,

İç Anadolu Bölgesinde Çölyak Hastalığının İdiyopatik İnfertilite ile İlişkisi

Aim: Celiac Disease (CD) is an inflammatory autoimmune disease that occurs in the small intestine of genetically predisposed individuals after gluten intake. CD leads to several gynecological and obstetrical problems. We aimed to investigate the prevalence of CD in patients with the diagnosis of idiopathic infertility in Central Anatolia. Patients and Methods: The study included 30 female patients who had the diagnosis of idiopathic infertility in the Erciyes UniversityFaculty of Medicine, gynecology and obstetrics clinic and 33 healthy women with at least one healthy pregnancy. The levels of AGA IGG/IGM, EMA, tTG, and IgG/IgM antibodies were measured in all patients and the study group. Upper gastrointestinal endoscopy and duodenal biopsy were performed for the individuals with a positive test result. Results: There was no significant difference in the presence of anemia, age, and body mass index between the groups. While AGA IGA was positive in four patients and AGA IGG was only positive in one patient in the patient group, AGA IGA was positive in three patients in the control group. In the control group, only one patient had a positive (EMA) test result; however, there was no positive result in any of the patients in the study group. TTG IgA antibodies were negative in both groups. Two patients had positive test in terms of TTG IgG in the control group. There was no statistically significant difference in terms of serological tests in both groups. Conclusion: The prevalence of CD in idiopathic infertile patients was similar to the control group. Further studies are needed to evaluate this relationship in this cohort.

Simposio 8: Nutrición en diabetes y enfermedad celíaca

Simposio 8: Tratamiento nutricional de la diabetes: nuevos horizontesNutrición en diabetes y enfermedad celíacaLa asociación genética existente entre diabetes mellitus (DM1) y enfermedad celíaca (EC) llevó a hipotetizar un posible mecanismo de daño tisular autoinmunitario común e, incluso, una posible intolerancia a antígenos presentes en la dieta como mecanismo etiológico de ambas enfermedades. En los últimos años se observó un aumento en la incidencia tanto de DM1 como de EC. Más del 90% de los individuos con EC y entre 60-70% de los DM1 expresan el mismo antígeno HLA DQA1*0501 y DQB1*0201. La EC puede hallarse en estado silente o subclínico en los DM1 en proporciones que varían entre 1 y 16%. La prevalencia de EC en pacientes con DM1 oscila entre el 1 y el 8%.

S0759 Celiac Disease in Patients With Inflammatory Bowel: Has the Inpatient Prevalence Changed and Is It Associated With Worse Outcome? A Nationwide Inpatient Sample Analysis

INTRODUCTION: Inflammatory bowel disease (IBD) and celiac disease (CeD) are immune-mediated diseases characterized by chronic intestinal inflammation. Some studies have suggested that patients with both IBD and CeD carry a higher risk of hospitalization and severe disease as compared with non-celiac IBD patients. This study aimed to evaluate the prevalence of CeD, the impact of CeD on outcomes among IBD hospitalizations and compare outcomes in subgroups of Crohn’s disease (CD) and ulcerative colitis (UC). METHODS: The NIS was used to identify adult patients with IBD hospitalizations from 2010 to 2014 using ICD-9 codes. Primary outcomes were mortality, hospital charges, length of stay (LOS) and colorectal surgery. The secondary outcome was the trend of the prevalence of CeD in IBD hospitalizations. Subgroup analysis was performed for UC with vs without CeD and CD with vs without CeD. Propensity scoring methods and multivariate regressions were used. RESULTS: There were 516,891 IBD related hospitalizations from 2010 to 2014, of which 1582 patients had CeD. The control group consisted of 7913 IBD hospitalizations without CeD. The average age of patients having CeD with IBD was 43.5 years old, 32.0% were male and 81.6% were Caucasian. IBD with CeD was associated with a lower rate of colorectal surgery compared to IBD without CeD (4.06% vs 5.90%, aOR 0.62, 95% CI = 0.47–0.81, P-value <0.001), but differences in mortality rate, LOS, and hospital charges were not significant. The prevalence of CeD in patients with IBD related hospitalizations increased from 0.23% to 0.45%. The annual percentage change (APC) of the prevalence of CeD in patients with IBD related hospitalizations was 0.058 (95% CI = 0.026–0.089, P-value <0.05). Subgroup analysis showed CeD was associated with a lower rate of colorectal surgery in adult patients with CD (1.2% vs 2.1%, aOR 0.36, 95% CI = 0.18–0.72, P-value <0.05) and was not associated with different outcomes in UC hospitalizations. CONCLUSION: The prevalence of CeD in IBD hospitalizations from 2010 to 2014 increased. This may be a result of increased awareness and testing for CeD. CeD was associated with a lower rate of colorectal surgery in CD and was not associated with different outcomes in UC. This may be explained by CD phenotypes with CeD that elicits a small bowel predominant presentation leading to lower colorectal surgery rates. Further studies are required to evaluate the pathogenesis of CD with CeD and its effects on clinical outcomes of hospitalized patients.Figure 1.: The trend in prevalence of celiac disease in patients with inflammatory bowel disease-related hospitalizations from 2010 to 2014.Table 1.: Comparison of baseline characteristics of patients admitted for inflammatory bowel disease (IBD) with celiac disease vs. without celiac diseaseTable 2.: Crude and Adjusted results for inpatient outcomes in patients with inflammatory bowel disease (IBD) with vs. without celiac disease from 2010 to 2014 *Adjusted for age, gender, race, primary insurance payer, hospital type, hospital bed size, Elixhauser comorbidity index score and income quartile

Prevalence of celiac disease in Iranian patients with type 1 diabetes: Asystematic review and meta-analysis.

Patients with type 1 diabetes mellitus (T1DM) are at high risk for celiac disease (CD) due to the common genetic background and interaction between environmental and immunological factors. The purpose of this systematic review and meta-analysis was to estimate the prevalence of CDamong Iranian patients with type 1 diabetes. The search for articles was conducted using the following keywords: "celiac disease," "celiac," "coeliac disease," "diabetes," "Iran," and all other possible combinations of these terms. The following databases were searched from inception to June 2019: Scientific Information Database (SID), MagIran, Web of Science, PubMed, and Scopus. Meta-analysis was performed using the random-effects models, and the heterogeneity of results across the studies was assessed using the Cochran's Q test and quantified by the I2 statistic. Data analysis was performed by Stata version 14. A total of 14 papers were included in the meta-analysis, involving 2030 Iranian patients with T1DM. The pooled prevalence of CD in patients with T1DM was 5% (95% CI 3-7). The prevalence of CD in Tehran (4%; 95% CI 1-6) was lower than in other provinces of the country (6%; 95% CI 4-8). Meta-regression analysis showed that, with increasing sample size, the prevalence of CD was significantly reduced (p = 0.018).Given the adverse effects of CD, such as osteoporosis and malignancy (especially lymphoma), patients with T1DM must be screened for CD.

Prevalence of celiac disease in patients with short stature: A systematic review and meta-analysis.

Short stature is a common extraintestinal manifestation of celiac disease (CeD). We conducted a systematic review and meta-analysis to assess the global prevalence of CeD in patients presenting with short stature. We searched Medline and EMBASE databases for the keywords "celiac disease, coeliac disease, anti-gliadin, tissue transglutaminase antibody, anti-endomysial antibody, short stature and growth retardation." All the studies published from January 1991 to May 2020 were included. Patients without any prior evaluation for short stature were classified as all-cause short stature, while prior evaluated patients, where no cause was found for short stature, were classified as idiopathic short stature. The diagnosis of CeD was based on the European Society for Paediatric Gastroenterology, Hepatology and Nutrition guidelines. A random-effects model was used to pool the data. Seventeen studies screening 3759 patients (1582 with all-cause short stature and 2177 with idiopathic short stature) were included. The pooled seroprevalence of CeD based on positive anti-tissue transglutaminase antibody and anti-endomysial antibody was 11.2% (95% CI 4.0-21.2%; I2 =86%) and 9.7% (95% CI 2.7-20.2%; I2 =95%) for all-cause and idiopathic short stature, respectively. Similarly, pooled prevalence of biopsy-confirmed CeD was 7.4% (95% CI 4.7-10.6%; I2 =76%) and 11.6% (95% CI 4.1-22.2%; I2 =97%), for all-cause and idiopathic short stature, respectively. There was an overall severe risk of selection bias and significant heterogeneity in the pooled results. Approximately one in 14 patients with all-cause short stature and one in nine patients with idiopathic short stature had biopsy-confirmed CeD. Therefore, evaluation for CeD may be prudent in all patients with short stature.

The Prevalence of Celiac Disease in a Fracture Liaison Service Population

Celiac disease (CD) is a known risk factor for osteoporosis and fractures. The prevalence of CD in patients with a recent fracture is unknown. We therefore systematically screened patients at a fracture liaison service (FLS) to study the prevalence of CD. Patients with a recent fracture aged ≥ 50 years were invited to VieCuri Medical Center’s FLS. In FLS attendees, bone mineral density (BMD) and laboratory evaluation for metabolic bone disorders and serological screening for CD was systematically evaluated. If serologic testing for CD was positive, duodenal biopsies were performed to confirm the diagnosis CD. Data were collected in 1042 consecutive FLS attendees. Median age was 66 years (Interquartile range (IQR) 15), 27.6% had a major and 6.9% a hip fracture, 26.4% had osteoporosis and 50.8% osteopenia. Prevalent vertebral fractures were found in 29.1%. CD was already diagnosed in two patients (0.19%), one still had a positive serology. Three other patients (0.29%) had a positive serology for CD (one with gastro-intestinal complaints). In two of them, CD was confirmed by duodenal histology (0.19%) and one refused further evaluation. The prevalence of biopsy-proven CD was therefore 0.38% (4/1042) of which 0.19% (2/1042) was newly diagnosed. The prevalence of CD in patients with a recent fracture at the FLS was 0.38% and within the range of reported prevalences in the Western-European population (0.33–1.5%). Newly diagnosed CD was only found in 0.19%. Therefore, standard screening for CD in FLS patients is not recommended.