Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 28, 2022; 28(12): 1272-1283
Published online Mar 28, 2022. doi: 10.3748/wjg.v28.i12.1272
Epidemiological, clinical, and histological presentation of celiac disease in Northwest China
Man Wang, Wen-Jie Kong, Yan Feng, Jia-Jie Lu, Wen-Jia Hui, Wei-Dong Liu, Zi-Qiong Li, Tian Shi, Mei Cui, Zhen-Zhu Sun, Feng Gao
Man Wang, Wen-Jie Kong, Yan Feng, Jia-Jie Lu, Wen-Jia Hui, Wei-Dong Liu, Zi-Qiong Li, Tian Shi, Feng Gao, Department of Gastroenterology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, Xinjiang Uygur Autonomous Region, China
Mei Cui, Zhen-Zhu Sun, Department of Pathology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, Xinjiang Uygur Autonomous Region, China
Author contributions: Wang M and Gao F designed the study; Wang M, Kong WJ, and Lu JJ acquired the data and drafted the article; Hui WJ and Liu WD analyzed and interpreted the data; Cui M and Sun ZZ made a pathological diagnosis; Feng Y, Li ZQ, Shi T and Gao F revised the article critically for important intellectual content; all the authors approved the version to be published.
Supported by National Natural Science Foundation of China, No. 81760101; and Natural Science Foundation of Xinjiang Uygur Autonomous Region, No. 2021D01C149.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of People’s Hospital of Xinjiang Uygur Autonomous Region.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Feng Gao, PhD, Chairman, Chief Doctor, Director, Professor, Department of Gastroenterology, People’s Hospital of Xinjiang Uygur Autonomous Region, No. 91 Tianchi Road, Tianshan District, Urumqi 830001, Xinjiang Uygur Autonomous Region, China. drxjgf@sina.com
Received: September 12, 2021
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
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

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.

Research objectives

To investigate the epidemiological, clinical, and pathological characteristics of CD in northwest China.

Research methods

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.

Research results

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.

Research conclusions

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.

Research perspectives

H. pylori infection may be related to the severity of CD, which warrants further study.