RÉSUMÉ
To evaluate the association between serum anti-tissue transglutaminase antibody (anti-tTG) titers and the severity of histological damage to the duodenal mucosa and to predict a possible anti-tTG cutoff value for diagnosing celiac disease (CD) and villous atrophy in the domestic population. Clinical and pathological data from 76 adult CD patients with positive anti-tTG titers and duodenal biopsy results who were treated at the People′s Hospital of Xinjiang Uygur Autonomous Region from July 2017 to January 2022 were retrospectively analyzed. The correlation between anti-tTG titers and the severity of duodenal mucosal damage was statistically assessed to predict the optimal anti-tTG titer cut-off value for diagnosing CD and villous atrophy. Of the 76 patients, 10 had underlying CD, and of the 66 patients with duodenal histopathology, four were Marsh Ⅰ, six were Marsh Ⅱ, and 56 were Marsh Ⅲa-c grade. In adults with CD, anti-tTG titers were shown to be associated with the severity of histological damage to the duodenal mucosa. When the anti-tTG level was ≥5 times the upper limit of normal (ULN), the sensitivity and specificity for diagnosing CD were 83.9% and 92.9%, respectively. When the anti-tTG titer was ≥8 times the ULN, the sensitivity and specificity for diagnosing villous atrophy were 67.9% and 90.0%, respectively. Anti-tTG levels had a strong predictive value for diagnosing CD in adults when titers exceeded 10 times the ULN. Thus, the anti-tTG cut-off value can be combined with clinical judgment to diagnose CD, limiting the use of invasive endoscopy.
RÉSUMÉ
Background:Celiac disease has a wide range of clinical manifestations and a higher prevalence in women.Aims:To evaluate the differences in clinical characteristics in adult celiac disease patients with different genders.Methods:Adult patients(age≥18 years)diagnosed as celiac disease from July 2017 to July 2022 at the People's Hospital of Xinjiang Uygur Autonomous Region were included consecutively in the retrospective study.Comparisons of baseline demography,and clinical and pathological features between different genders were performed.Results:A total of 73 adult celiac disease patients were enrolled,19 were males and 54 were females,with the ratio of male to female being 1:2.84.The peak age group of onset was 30-59 years old,with an average age of(50.2±13.6)years for men and(43.5±13.2)years for women at diagnosis.There was no significant difference in the distribution of different age groups between men and women(P>0.05),but the proportion of women in 18-49 years age group and≥50 years age group were both higher than that of men with statistical significance(P<0.05).The most common gastrointestinal symptoms were chronic diarrhea(56.2%)and abdominal pain(56.2%),and anemia was the most common extraintestinal manifestation(50.7%),which was existed in 36.8%of males and 55.6%of females.Abdominal pain and nausea/vomiting were more common in females(all P<0.05),whereas no statistically significant differences were found between male and female groups in other gastrointestinal and extraintestinal manifestations,such as chronic diarrhea,flatulence,decreased appetite,weight loss,chronic fatigue,anemia,hypoproteinemia,osteoporosis/bone loss,etc(all P>0.05).The pathological grading of small intestinal biopsy was Marsh Ⅱin 6 cases,and Marsh Ⅲa,Ⅲb and Ⅲc in 14,23,and 30 cases,respectively.No statistically significant difference was observed in pathological grading between patients with different genders(P>0.05).Conclusions:There is a marked female predominance in adult celiac disease in Xinjiang Uygur Autonomous Region,and women were diagnosed at a younger age.Chronic diarrhea,abdominal pain and anemia present as the most common gastrointestinal and extraintestinal manifes-tations.Abdominal pain and nausea/vomiting are more common in women than in men.
RÉSUMÉ
Intestinal microbes play a vital role in the development of colorectal diseases.Fusobacterium nucleatum (Fn), an commensal resident in the human gut, is closely associated with colorectal diseases, and attracted widespread attention.Studies have found that Fn may contribute to the development and prognosis of inflammation and colorectal cancer.This article reviews the research advances of the relationship between Fn and the development of colorectal diseases.