Serological Survey In High-risk Population Of Celiac Disease In Guangdong Province And Meta-analysis

BackgroundCeliac disease(CD)is an autoimmune bowel disease caused by gluten in the diet in genetically susceptible individuals.In European countries,the prevalence of celiac disease in the general population is about 1%.Over the past two decades,celiac disease has become a global public health problem.With the research of celiac disease,the epidemiological study of celiac disease has been carried out in the Middle East,India and other countries,and the prevalence data of celiac disease in several area have been reported.Celiac disease overlaps considerably with many autoimmune diseases.In patients with irritable bowel syndrome(IBS)and type 1 diabetes(T1DM),the incidence of celiac disease increased significantly.Celiac disease and rheumatoid arthritis(RA)have similar antigen expression and T-cell activation pathways,and there are extensive genetic overlaps with other autoimmune diseases,including inflammatory bowel disease(IBD),colitis,psoriasis,psoriasis,and so on.AimTo investigate the seropositive rate of celiac disease in high-risk population in Guangdong Province.According to epidemiological studies,the high-risk group of celiac disease was defined as patients with irritable bowel syndrome(IBS),type 1 diabetes(T1DM),rheumatoid arthritis(RA),ankylosing spondylitis(AS),colitis,diarrhea,psoriasis,anemia,and patients with low BMI,short stature,and higher score in Bristol.The seropositive rate obtained by testing serum celiac antibodies in the high-risk groups was assessed,which provided epidemiological evidence for the screening and diagnosis of celiac disease.In addition,research on celiac disease in Asia has been progressing gradually in recent years,but the exact incidence of celiac disease in the general population and high-risk population in China is unclear.Our team conducted a meta-analysis of clinical data published in the field of celiac disease in China to obtain the pooled incidence of celiac disease in the general population and high-risk population in China.Results1273 patients underwent serological test and the overall serum positive rate was 0.94%(12/1273).The positive rate of anti-tTG IgA was 0.08%(1/1271).A meta-analysis showed that the seropositivity rate of celiac disease in the general Chinese population was 0.27%(95%CI,0.02%-0.71%).The seropositive rate of celiac disease in the general population in northern China was 0.62%(95%CI,0.06%-1.55%),which was significantly higher than 0.21%(95%CI,0.00%-0.58%)in the general population in the southern China.At the same time,the seropositivity rate of high-risk populations in China was significantly higher than that of the general population(OR 0.18,95%CI,0.10-0.34).ConclusionHigh-risk groups in this study had a high seropositive rate of celiac disease(1.08%-3.57%),suggesting that high-risk population should be screened for celiac disease by serological testing.Celiac disease is not rare in the general population of China,especially in Northern China,which requires further screening and clinical research.