Pancreatic Exocrine Insufficiency Is Not Uncommon in Celiac Disease: A Systematic Review and Meta-Analysis.

IF 5.8 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

United European Gastroenterology Journal Pub Date : 2025-07-09 DOI:10.1002/ueg2.70076

Miroslav Vujasinovic, Nina Blazevic, Patrick Maisonneuve, Anders Forss, Nikola Panic, Nina Bloch, J Enrique Dominguez Munoz, Jonas F Ludvigsson, J-Matthias Löhr

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引用次数: 0

Abstract

Introduction: Pancreatic exocrine insufficiency (PEI) is seen in primary pancreatic disease but has also been seen in extrapancreatic conditions including celiac disease (CeD). The symptoms of PEI and CeD often overlap, which makes diagnostics challenging. In this systematic review and meta-analysis, we aimed to investigate the prevalence of PEI in CeD.

Methods: With the assistance of a professional librarian, we searched five databases: PubMed, Embase, Cochrane, Web of Science Core Collection, and Google Scholar, up until October 21, 2024. The pooled prevalence of PEI in biopsy-confirmed CeD was estimated, and the quality of studies appraised.

Results: We identified and screened the titles and abstracts of 1432 publications, of which 60 were reviewed in full text and 12 were included in the analyses. The overall pooled weighted prevalence of PEI in CeD was 13.5% (95% CI 7.2-21.0). The prevalence was similar among children (14.2%; 95% CI 2.0-32.8) and adults (12.8%; 95% CI 7.8-18.7) with CeD. The prevalence in studies that used secretory testing to define PEI was 13.1% (95% CI 6.4-21.3) and in those requiring digestive tests 17.1% (95% CI 5.8-32.1). The weighted prevalence of PEI was significantly higher among untreated CeD patients (18.2%) than patients on a gluten-free diet (6.9%) (p = 0.03), in both adults and children.

Conclusion: One in eight individuals with CeD may suffer from PEI. The prevalence was particularly high in untreated CeD. PEI should be considered in patients who do not respond to a gluten-free diet.

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胰外分泌功能不全在乳糜泻中并不罕见：一项系统综述和荟萃分析。

胰腺外分泌功能不全（PEI）见于原发性胰腺疾病，但也见于胰外疾病，包括乳糜泻（CeD）。PEI和CeD的症状经常重叠，这使得诊断具有挑战性。在这篇系统综述和荟萃分析中，我们旨在调查PEI在CeD中的患病率。方法：在专业图书馆员的协助下，检索PubMed、Embase、Cochrane、Web of Science Core Collection和谷歌Scholar 5个数据库，检索时间截止至2024年10月21日。估计活检证实的CeD中PEI的总患病率，并评估研究的质量。结果：我们筛选了1432篇出版物的标题和摘要，其中60篇被全文审阅，12篇被纳入分析。PEI在CeD中的总体合并加权患病率为13.5% （95% CI 7.2-21.0）。儿童患病率相似(14.2%；95% CI 2.0-32.8)和成人(12.8%；95% CI 7.8-18.7)。在使用分泌物测试来定义PEI的研究中，患病率为13.1% (95% CI 6.4-21.3)，在需要消化测试的研究中患病率为17.1% （95% CI 5.8-32.1）。在成人和儿童中，未经治疗的CeD患者的PEI加权患病率（18.2%）显著高于无麸质饮食患者（6.9%）（p = 0.03）。结论：1 / 8的CeD患者可能患有PEI。在未经治疗的CeD中患病率特别高。对无麸质饮食无反应的患者应考虑PEI。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

United European Gastroenterology Journal GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

10.50

自引率

13.30%

发文量

147

期刊介绍： United European Gastroenterology Journal (UEG Journal) is the official Journal of the United European Gastroenterology (UEG), a professional non-profit organisation combining all the leading European societies concerned with digestive disease. UEG’s member societies represent over 22,000 specialists working across medicine, surgery, paediatrics, GI oncology and endoscopy, which makes UEG a unique platform for collaboration and the exchange of knowledge.