Prevalence of serum celiac antibody in patients with IBD in Japan

Abstract

Background: Although the incidence of inflammatory bowel diseases (IBD) in Japan has increased, the prevalence of celiac disease is considered very low with the lowest genetic disposition. IBD is reported as the most common comorbidity because of the high positive rate of serological celiac markers. The aim of this study was to examine the current incidence of celiac disease, especially in IBD patients in Japan, where both wheat consumption and incidence of IBD have increased.

Methods: A total of 172 patients with IBD and 190 controls in Japan were screened for serum antibody of tissue transglutaminase and deaminated gliadin peptide. In sero-positive patients, HLA testing and upper gastrointestinal endoscopy with duodenal biopsy was performed. Some of the sero-positive patients started a gluten-restricted or unrestricted diet, and serological change was determined.

Results: The positivity of both serum antibodies was significantly higher in IBD and correlated with disease activity. However, no biopsy-defined or HLA-defined true celiac disease was found. A decrease in serum antibody titers was observed with a gluten-restricted diet.

Conclusions: Despite the increased incidence of IBD and high positivity for serum celiac antibody in Japanese IBD patients, no true-positive celiac disease was noted, suggesting the presence of gluten intolerance in these populations.

Fig. 1

Serum concentration of celiac disease specific antibodies in IBD and control. Serum concentration of serum a tTG and b DGP in IBD and control. Dashed lines indicate the upper limit of normal level based on manufacturer’s provided cut-off values. The p values refer to the Mann-Whitney test calculated in IBD patients vs. controls 254 × 190 mm (96 × 96 DPI)

Fig. 2

Effect of gluten restriction on sero-positive patients. Effect of gluten restriction on sero-positive patients. Serum a tTG and c DGP of the participants before and after 6 month with gluten restricted diet. Serum b tTG and d DGP of the participants with before and after 6 month with gluten unrestricted diet. Asterisk change within the group significant compared with baseline; p < 0.01 190 × 254 mm (96 × 96 DPI)