Non-invasive prediction of persistent villous atrophy in celiac
disease

J 2020

Non-invasive prediction of persistent villous atrophy in celiac disease

PACKOVÁ, Barbora, Petra KOVALČÍKOVÁ, Zdeněk PAVLOVSKÝ, Daniel BARTUŠEK, Jitka PROKEŠOVÁ et. al.

Základní údaje

Originální název

Non-invasive prediction of persistent villous atrophy in celiac disease

Autoři

PACKOVÁ, Barbora (203 Česká republika, domácí), Petra KOVALČÍKOVÁ (203 Česká republika, domácí), Zdeněk PAVLOVSKÝ (203 Česká republika, domácí), Daniel BARTUŠEK (203 Česká republika, domácí), Jitka PROKEŠOVÁ (203 Česká republika, domácí), Jiří DOLINA (203 Česká republika, domácí) a Radek KROUPA (203 Česká republika, garant, domácí)

Vydání

World Journal of Gastroenterology, PLEASANTON, Baishideng, 2020, 1007-9327

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30219 Gastroenterology and hepatology

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 5.742

Kód RIV

RIV/00216224:14110/20:00116252

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.3748/wjg.v26.i26.3780

UT WoS

000556653500006

Klíčová slova anglicky

Celiac disease; Villous atrophy; Anti-tissue transglutaminase antibodies; Anti-deamidated gliadin peptide antibodies; Abdominal ultrasound; Gluten-free diet

Štítky

14110213, 14110216, 14110230, 14119612, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 12. 5. 2021 13:41, Mgr. Tereza Miškechová

Anotace

V originále

BACKGROUND Celiac disease (CD) is an immune-mediated enteropathy that is primarily treated with a gluten-free diet (GFD). Mucosal healing is the main target of the therapy. Currently, duodenal biopsy is the only way to evaluate mucosal healing, and non-invasive markers are challenging. Persistent elevation of anti-tissue transglutaminase antibodies (aTTG) is not an ideal predictor of persistent villous atrophy (VA). Data regarding prediction of atrophy using anti-deamidated gliadin peptide antibodies (aDGP) and abdominal ultrasonography are lacking. AIM To evaluate the ability of aTTG, aDGP, small bowel ultrasonography, and clinical and laboratory parameters in predicting persistent VA determined using histology. METHODS Patients with CD at least 1 year on a GFD and available follow-up duodenal biopsy, levels of aTTG and aDGP, and underwent small bowel ultrasonography were included in this retrospective cohort study. We evaluated the sensitivity, specificity, and positive and negative predictive values of aTTG, aDGP, small bowel ultrasonography, laboratory and clinical parameters to predict persistent VA. A receiver operating characteristic (ROC) curve analysis of antibody levels was used to calculate cut off values with the highest accuracy for atrophy prediction. RESULTS Complete data were available for 82 patients who were followed up over a period of four years (2014-2018). Among patients included in the analysis, women (67, 81.7%) were predominant and the mean age at diagnosis was 33.8 years. Follow-up biopsy revealed persistent VA in 19 patients (23.2%). The sensitivity and specificity of aTTG using the manufacturer's diagnostic cutoff value to predict atrophy was 50% and 85.7%, respectively, while the sensitivity and specificity of aDGP (using the diagnostic cutoff value) was 77.8% and 75%, respectively. Calculation of an optimal cutoff value using ROC analysis (13.4 U/mL for aTTG IgA and 22.6 U/mL for aDGP IgA) increased the accuracy and reached 72.2% [95% confidence interval (CI): 46.5-90.3] sensitivity and 90% (95%CI: 79.5-96.2) specificity for aDGP IgA and 66.7% (95%CI: 41.0-86.7) sensitivity and 93.7% (95%CI: 84.5-98.2) specificity for aTTG IgA. The sensitivity and specificity of small bowel ultrasonography was 64.7% and 73.5%, respectively. A combination of serology with ultrasound imaging to predict persistent atrophy increased the positive predictive value and specificity to 88.9% and 98% for aTTG IgA and to 90.0% and 97.8% for aDGP IgA. Laboratory and clinical parameters had poor predictive values. CONCLUSION The sensitivity, specificity, and negative predictive value of aTTG and aDGP for predicting persistent VA improved by calculating the best cutoff values. The combination of serology and experienced bowel ultrasound examination may achieve better accuracy for the detection of atrophy.

Citovat

PACKOVÁ, Barbora, Petra KOVALČÍKOVÁ, Zdeněk PAVLOVSKÝ, Daniel BARTUŠEK, Jitka PROKEŠOVÁ, Jiří DOLINA a Radek KROUPA. Non-invasive prediction of persistent villous atrophy in celiac disease. World Journal of Gastroenterology. PLEASANTON: Baishideng, 2020, roč. 26, č. 26, s. 3780-3791. ISSN 1007-9327. Dostupné z: https://dx.doi.org/10.3748/wjg.v26.i26.3780.

@article{1674819,
   author = {Packová, Barbora and Kovalčíková, Petra and Pavlovský, Zdeněk and Bartušek, Daniel and Prokešová, Jitka and Dolina, Jiří and Kroupa, Radek},
   article_location = {PLEASANTON},
   article_number = {26},
   doi = {http://dx.doi.org/10.3748/wjg.v26.i26.3780},
   keywords = {Celiac disease; Villous atrophy; Anti-tissue transglutaminase antibodies; Anti-deamidated gliadin peptide antibodies; Abdominal ultrasound; Gluten-free diet},
   language = {eng},
   issn = {1007-9327},
   journal = {World Journal of Gastroenterology},
   title = {Non-invasive prediction of persistent villous atrophy in celiac disease},
   url = {https://www.wjgnet.com/1007-9327/full/v26/i26/3780.htm},
   volume = {26},
   year = {2020}
}

TY  - JOUR
ID  - 1674819
AU  - Packová, Barbora - Kovalčíková, Petra - Pavlovský, Zdeněk - Bartušek, Daniel - Prokešová, Jitka - Dolina, Jiří - Kroupa, Radek
PY  - 2020
TI  - Non-invasive prediction of persistent villous atrophy in celiac disease
JF  - World Journal of Gastroenterology
VL  - 26
IS  - 26
SP  - 3780-3791
EP  - 3780-3791
PB  - Baishideng
SN  - 10079327
KW  - Celiac disease
KW  - Villous atrophy
KW  - Anti-tissue transglutaminase antibodies
KW  - Anti-deamidated gliadin peptide antibodies
KW  - Abdominal ultrasound
KW  - Gluten-free diet
UR  - https://www.wjgnet.com/1007-9327/full/v26/i26/3780.htm
L2  - https://www.wjgnet.com/1007-9327/full/v26/i26/3780.htm
N2  - BACKGROUND Celiac disease (CD) is an immune-mediated enteropathy that is primarily treated with a gluten-free diet (GFD). Mucosal healing is the main target of the therapy. Currently, duodenal biopsy is the only way to evaluate mucosal healing, and non-invasive markers are challenging. Persistent elevation of anti-tissue transglutaminase antibodies (aTTG) is not an ideal predictor of persistent villous atrophy (VA). Data regarding prediction of atrophy using anti-deamidated gliadin peptide antibodies (aDGP) and abdominal ultrasonography are lacking. AIM To evaluate the ability of aTTG, aDGP, small bowel ultrasonography, and clinical and laboratory parameters in predicting persistent VA determined using histology. METHODS Patients with CD at least 1 year on a GFD and available follow-up duodenal biopsy, levels of aTTG and aDGP, and underwent small bowel ultrasonography were included in this retrospective cohort study. We evaluated the sensitivity, specificity, and positive and negative predictive values of aTTG, aDGP, small bowel ultrasonography, laboratory and clinical parameters to predict persistent VA. A receiver operating characteristic (ROC) curve analysis of antibody levels was used to calculate cut off values with the highest accuracy for atrophy prediction. RESULTS Complete data were available for 82 patients who were followed up over a period of four years (2014-2018). Among patients included in the analysis, women (67, 81.7%) were predominant and the mean age at diagnosis was 33.8 years. Follow-up biopsy revealed persistent VA in 19 patients (23.2%). The sensitivity and specificity of aTTG using the manufacturer's diagnostic cutoff value to predict atrophy was 50% and 85.7%, respectively, while the sensitivity and specificity of aDGP (using the diagnostic cutoff value) was 77.8% and 75%, respectively. Calculation of an optimal cutoff value using ROC analysis (13.4 U/mL for aTTG IgA and 22.6 U/mL for aDGP IgA) increased the accuracy and reached 72.2% [95% confidence interval (CI): 46.5-90.3] sensitivity and 90% (95%CI: 79.5-96.2) specificity for aDGP IgA and 66.7% (95%CI: 41.0-86.7) sensitivity and 93.7% (95%CI: 84.5-98.2) specificity for aTTG IgA. The sensitivity and specificity of small bowel ultrasonography was 64.7% and 73.5%, respectively. A combination of serology with ultrasound imaging to predict persistent atrophy increased the positive predictive value and specificity to 88.9% and 98% for aTTG IgA and to 90.0% and 97.8% for aDGP IgA. Laboratory and clinical parameters had poor predictive values. CONCLUSION The sensitivity, specificity, and negative predictive value of aTTG and aDGP for predicting persistent VA improved by calculating the best cutoff values. The combination of serology and experienced bowel ultrasound examination may achieve better accuracy for the detection of atrophy.
ER  -

PACKOVÁ, Barbora, Petra KOVALČÍKOVÁ, Zdeněk PAVLOVSKÝ, Daniel BARTUŠEK, Jitka PROKEŠOVÁ, Jiří DOLINA a Radek KROUPA. Non-invasive prediction of persistent villous atrophy in celiac disease. \textit{World Journal of Gastroenterology}. PLEASANTON: Baishideng, 2020, roč.~26, č.~26, s.~3780-3791. ISSN~1007-9327. Dostupné z: https://dx.doi.org/10.3748/wjg.v26.i26.3780.

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