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©The Author(s) 2020.
World J Gastroenterol. Jul 14, 2020; 26(26): 3780-3791
Published online Jul 14, 2020. doi: 10.3748/wjg.v26.i26.3780
Published online Jul 14, 2020. doi: 10.3748/wjg.v26.i26.3780
Table 1 Summary of patient characteristics at the time of biopsy on gluten-free diet
| Characteristic | Category | All patients with celiac disease (n = 82) | |
| n | % | ||
| Gender | Female | 67 | 81.7 |
| Male | 15 | 18.3 | |
| Villous atrophy | No | 63 | 76.8 |
| Yes | 19 | 23.2 | |
| Marsh in follow-up biopsy | Marsh 0 | 44 | 53.7 |
| Marsh 1 | 19 | 23.2 | |
| Marsh 3a | 10 | 12.2 | |
| Marsh 3b | 4 | 4.9 | |
| Marsh 3c | 5 | 6.1 | |
| Autoantibodies aTTG | Negative | 63 | 77.8 |
| Positive | 18 | 22.2 | |
| Unknown | 1 | 1.2 | |
| Autoantibodies aDGP | Negative | 49 | 62.8 |
| Positive | 29 | 37.2 | |
| Unknown | 4 | 4.9 | |
| Diarrhea | No | 62 | 75.6 |
| Yes | 19 | 23.2 | |
| Unknown | 1 | 1.2 | |
| Weight loss | No | 73 | 89.0 |
| Yes | 8 | 9.8 | |
| Unknown | 1 | 1.2 | |
| Abdominal pain | No | 64 | 78.0 |
| Yes | 17 | 20.7 | |
| Unknown | 1 | 1.2 | |
| Anemia | No | 71 | 86.6 |
| Yes | 9 | 11.0 | |
| Unknown | 2 | 2.4 | |
| Sideropenia | No | 58 | 70.7 |
| Yes | 22 | 26.8 | |
| Unknown | 2 | 2.4 | |
| Vitamin D deficiency | No | 63 | 76.8 |
| Yes | 17 | 20.7 | |
| Unknown | 2 | 2.4 | |
| Ultrasonography | Negative | 42 | 51.2 |
| Positive | 24 | 29.3 | |
| Unknown | 16 | 19.5 | |
Table 2 Comparison of characteristics according to persistence of villous atrophy
| Characteristics | Category | No villous atrophy (n = 63) | Villous atrophy (n = 19) | |
| n (%) | n (%) | P value | ||
| Gender | Female | 52 (82.5) | 15 (78.9) | 0.741 |
| Male | 11 (17.5) | 4 (21.1) | ||
| Follow-up biopsy | Less than 2 years | 10 (15.9) | 1 (5.3) | 0.147 |
| Two years and more | 53 (84.1) | 17 (89.5) | ||
| Unknown | 0 (0.0) | 1 (5.3) | ||
| Mean (SD) | Mean (SD) | P value | ||
| Length of disease at follow-up biopsy (yr) | 7.9 (8.2) | 13.1 (13.4) | 0.092 | |
| Age at follow-up biopsy (yr) | 32.3 (14.6) | 38.7 (24.4) | 0.231 | |
Table 3 Comparison of autoantibodies´ positivity, ultrasonography, laboratory and clinical markers in patients with and without villous atrophy, in groups with available parameters
| Characteristics | Categories | Villous atrophy | ||
| Yes (%) | No (%) | P value | ||
| Autoantibodies aTTG (n = 81) | Positive | 9 (50) | 9 (14.3) | 0.003b |
| Negative | 9 (50) | 54 (85.7) | ||
| Total | 18 (100) | 63 (100) | ||
| Autoantibodies aDGP (n = 78) | Positive | 14 (77.8) | 15 (25) | < 0.001b |
| Negative | 4 (22.2) | 45 (75) | ||
| Total | 18 (100) | 60 (100) | ||
| Autoantibodies aTTG IgA (n = 81) | Positive | 9 (50) | 2 (3.2) | < 0.001b |
| Negative | 9 (50) | 61 (96.8) | ||
| Total | 18 (100) | 63 (100) | ||
| Autoantibodies aTTG IgG (n = 81) | Positive | 1 (5.6) | 7 (11.1) | 0.677 |
| Negative | 17 (94.4) | 56 (88.9) | ||
| Total | 18 (100) | 63 (100) | ||
| Autoantibodies aDGP IgA (n = 78) | Positive | 13 (72.2) | 11 (18.3) | < 0.001b |
| Negative | 5 (27.8) | 49 (81.7) | ||
| Total | 18 (100) | 60 (100) | ||
| Autoantibodies aDGP IgG (n = 78) | Positive | 11 (61.1) | 9 (15) | < 0.001b |
| Negative | 7 (38.9) | 51 (85) | ||
| Total | 18 (100) | 60 (100) | ||
| Ultrasonography (n = 66) | Positive | 11 (64.7) | 13 (26.5) | 0.008b |
| Negative | 6 (35.3) | 36 (73.5) | ||
| Total | 17 (100) | 49 (100) | ||
| Diarrhea (n = 81) | Yes | 8 (44.4) | 11 (17.5) | 0.027a |
| No | 10 (55.6) | 52 (82.5) | ||
| Total | 18 (100) | 63 (100) | ||
| Yes | 4 (22.2) | 4 (6.4) | 0.068 | |
| Weight loss (n = 81) | No | 14 (77.8) | 59 (93.6) | |
| Total | 18 (100) | 63 (100) | ||
| Abdominal pain (n = 81) | Yes | 3 (16.7) | 14 (22.2) | 0.751 |
| No | 15 (83.3) | 49 (77.8) | ||
| Total | 18 (100) | 63 (100) | ||
| Anemia (n = 80) | Positive | 1 (5.6) | 8 (12.9) | 0.676 |
| Negative | 17 (94.4) | 54 (87.1) | ||
| Total | 18 (100) | 62 (100) | ||
| Sideropenia (n = 80) | Positive | 4 (22.2) | 18 (29) | 0.766 |
| Negative | 14 (77.8) | 44 (71) | ||
| Total | 18 (100) | 62 (100) | ||
| Vitamin D deficiency (n = 80) | Positive | 8 (44.4) | 9 (14.5) | 0.018a |
| Negative | 10 (55.6) | 53 (85.5) | ||
| Total | 18 (100) | 62 (100) | ||
Table 4 Sensitivity, specificity, positive and negative predictive value of anti-tissue transglutaminase antibodies and anti-deamidated gliadin peptide antibodies autoantibodies (with standard cutoff values according to laboratory references 18 U/mL for anti-tissue transglutaminase antibodies and 20 U/mL for anti-deamidated gliadin peptide antibodies) for prediction of villous atrophy in patients with celiac disease
| Characteristics | Sensitivity (%) (95%CI) | Specificity (%) (95%CI) | Accuracy (%) (95%CI) | Positive predictive value (%) (95%CI) | Negative predictive value (%) (95%CI) |
| Autoantibodies aTTG | 50.0 (26.0-74.0) | 85.7 (74.6-93.3) | 77.8 (67.2-86.3) | 50.0 (31.8-68.2) | 85.7 (78.9-90.6) |
| Autoantibodies aDGP | 77.8 (52.4-93.6) | 75.0 (62.1-85.3) | 75.6 (64.6-84.7) | 48.3 (36.1-60.7) | 91.8 (82.4-96.4) |
| Autoantibodies aTTG IgA | 50.0 (26.0-74.0) | 96.8 (89.0-99.6) | 86.4 (77.0-93.0) | 81.8 (51.6-95.0) | 87.1 (81.0-91.5) |
| Autoantibodies aTTG IgG | 5.6 (0.1-27.3) | 88.9 (78.4-95.4) | 70.4 (59.2-80.0) | 12.5 (1.8-52.1) | 76.7 (74.1-79.2) |
| Autoantibodies aDGP IgA | 72.2 (46.5-90.3) | 81.7 (69.6-90.5) | 79.5 (68.8-87.8) | 54.2 (39.2-68.4) | 90.7 (82.2-95.4) |
| Autoantibodies aDGP IgG | 61.1 (35.8-82.7) | 85.0 (73.4-92.9) | 79.5 (68.8-87.8) | 55.0 (37.6-71.2) | 87.9 (80.2-92.9) |
Table 5 Sensitivity, specificity, positive and negative predictive value of recalculated cutoff values of anti-tissue transglutaminase antibodies and anti-deamidated gliadin peptide antibodies autoantibodies titers and their combination with small bowel ultrasonography for prediction of villous atrophy in patients with celiac disease
| Characteristics | Sensitivity (%) (95%CI) | Specificity (%) (95%CI) | Accuracy (%) (95%CI) | Positive predictive value (%) (95%CI) | Negative predictive value (%) (95%CI) |
| Autoantibodies aTTG IgA (cutoff: 13.4) | 66.7 (41.0-86.7) | 93.7 (84.5-98.2) | 87.7 (78.5-93.9) | 75.0 (52.4-89.1) | 90.8 (83.6-95.0) |
| Autoantibodies aTTG IgG (cutoff: 6.7) | 33.3 (13.3-59.0) | 87.3 (76.5-94.4) | 75.3 (64.5-84.2) | 42.9 (23.0-65.3) | 82.1 (76.5-86.6) |
| Autoantibodies aDGP IgA (cutoff: 22.6) | 72.2 (46.5-90.3) | 90.0 (79.5-96.2) | 85.9 (76.2-92.7) | 68.4 (49.1-83.0) | 91.5 (83.6-95.8) |
| Autoantibodies aDGP IgG (cutoff: 28.8) | 61.1 (35.8-82.7) | 90.0 (79.5-96.2) | 83.3 (73.2-90.8) | 64.7 (44.1-81.0) | 88.5 (81.1-93.3) |
| Autoantibodies aTTG IgA (cutoff 13.4) AND ultrasonography | 47.1 (23.0-72.2) | 98.0 (89.2-99.9) | 84.9 (73.9-92.5) | 88.9 (51.9-98.3) | 84.2 (77.3-89.3) |
| Autoantibodies aDGP IgA (cutoff 22.6) AND ultrasonography | 52.9 (27.8-77.0) | 97.8 (88.5-99.9) | 85.7 (74.6-93.3) | 90.0 (55.2-98.5) | 84.9 (77.2-90.3) |
Table 6 Sensitivity, specificity, positive and negative predictive value of bowel ultrasonography, clinical and laboratory markers for prediction of villous atrophy in patients with celiac disease
| Characteristics | Sensitivity (%) (95%CI) | Specificity (%) (95%CI) | Accuracy (%) (95%CI) | Positive predictive value (%) (95%CI) | Negative predictive value (%) (95%CI) |
| Ultrasonography | 64.7 (38.3-85.8) | 73.5 (58.9-85.1) | 71.2 (58.8-81.7) | 45.8 (32.1-60.3) | 85.7 (75.5-92.1) |
| Diarrhea | 44.4 (21.5-69.2) | 82.5 (70.9-91.0) | 74.1 (63.1-83.2) | 42.1 (25.7-60.5) | 83.9 (77.2-88.9) |
| Weight loss | 22.2 (6.4-47.6) | 93.7 (84.5-98.2) | 77.8 (67.2-86.3) | 50.0 (21.7-78.3) | 80.8 (76.6-84.5) |
| Abdominal pain | 16.7 (3.6-41.4) | 77.8 (65.5-87.3) | 64.2 (52.8-74.6) | 17.7 (6.5-39.9) | 76.6 (71.9-80.7) |
| Anemia | 5.6 (0.1-27.3) | 87.1 (76.2-94.3) | 68.8 (57.4-78.7) | 11.1 (1.6-48.3) | 76.1 (73.3-78.6) |
| Sideropenia | 22.2 (6.4-47.6) | 71.0 (58.1-81.8) | 60.0 (48.4-70.8) | 18.2 (7.9-36.4) | 75.9 (70.1-80.8) |
| Vitamin D deficiency | 44.4 (21.5-69.2) | 85.5 (74.2-93.1) | 76.3 (65.4-85.1) | 47.1 (28.7-66.3) | 84.1 (77.6-89.0) |
- Citation: Packova B, Kovalcikova P, Pavlovsky Z, Bartusek D, Prokesova J, Dolina J, Kroupa R. Non-invasive prediction of persistent villous atrophy in celiac disease. World J Gastroenterol 2020; 26(26): 3780-3791
- URL: https://www.wjgnet.com/1007-9327/full/v26/i26/3780.htm
- DOI: https://dx.doi.org/10.3748/wjg.v26.i26.3780