Published online Mar 28, 2022. doi: 10.3748/wjg.v28.i12.1272
Peer-review started: September 12, 2021
First decision: October 16, 2021
Revised: November 16, 2021
Accepted: February 27, 2022
Article in press: February 27, 2022
Published online: March 28, 2022
Research on celiac disease (CD) in northwest China is still in its infancy. At present, large-sample data on the epidemiological, clinical, and pathological characteristics of CD are limited.
To investigate the epidemiological, clinical, and pathological characteristics of CD in northwest China.
The clinical data of 2884 patients with gastrointestinal (GI) symptoms were retrospectively analyzed. Total immunoglobulin A (IgA) and anti-tissue transglutaminase (tTG) IgA levels were examined in all patients. Gastroscopy and colonoscopy were performed in patients with positive anti-tTG IgA and deficient total IgA levels. Atrophy of the duodenal and ileal villi was examined and histopathological examinations were performed. The modified Marsh–Oberhuber classification system was used to grade villous atrophy in the duodenum or distal ileum. The patients’ Helicobacter pylori (H. pylori) infection status was compared in terms of clinical presentation and Marsh grade. Statistical analyses were performed using the t-test or chi-square test.
Among the 2884 patients, 73 were positive for serum anti-tTG IgA, and 50 were diagnosed with CD. The CD detection rate was significantly higher in Kazakhs (4.39%) than in Uyghurs (2.19%), Huis (0.71%), and Hans (0.55%). The main symptoms of CD were chronic diarrhea, anorexia, anemia, fatigue, weight loss, sleep disorders, osteopenia, and osteoporosis. The body mass index of patients with CD was significantly lower than that of patients without CD. A total of 69 patients with positive serum anti-tTG IgA and two patients with deficient total IgA levels underwent GI endoscopy. Endoscopy revealed crypt hyperplasia and/or duodenal villous atrophy, mainly manifested as nodular mucosal atrophy, grooves, and fissures. The difference in H. pylori infection rates was not statistically significant between CD and non-CD patients but was significantly different among CD patients with different Marsh grades.
Among the patients with GI symptoms in northwestern China, the prevalence of CD was more in the Uyghur and Kazakh populations. H. pylori infection may be associated with CD severity.
Core Tip: Celiac disease (CD) is an autoimmune disease caused by the ingestion of gluten in genetically susceptible individuals. The global prevalence of CD is approximately 1.4%. An increase in celiac-specific autoantibody levels can lead to varying degrees of damage to the small intestinal mucosa and consequently to various gastrointestinal and systemic symptoms. This study reports the epidemiological, clinical, and pathological characteristics of CD and its association with Helicobacter pylori infection and aims to provide useful information for the clinical diagnosis and treatment of CD.