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.
This study reports the epidemiological, clinical, and pathological characteristics of CD and its association with Helicobacter pylori (H. pylori) infection, and aims to provide useful information for clinical diagnosis and treatment of CD.
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 and anti-tissue transglutaminase (tTG) immunoglobulin A (IgA) levels were examined for 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. Patient H. pylori infection status was compared in terms of clinical presentation and Marsh grade. Statistical analyses were performed using t-test or chi-square test.
The detection rate of CD was significantly higher in Kazakhs (4.39%) than in Uygurs (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 CD patients was significantly lower than that of non-CD patients. Endoscopy revealed crypt hyperplasia and/or duodenal villous atrophy, which 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. Patients with H. pylori infection were more commonly found with Marsh grade 2 and more patients without H. pylori had Marsh grade 3b.
Among people with GI symptoms in Northwest China, the prevalence of CD is higher in the Uygur and Kazak populations. Physicians should be aware of the risk of CD in the regional population. H. pylori infection may be related to the severity of CD, which warrants further study.
H. pylori infection may be related to the severity of CD, which warrants further study.