Comparison of six human anti-transglutaminase ELISA-tests in the diagnosis of celiac disease in the Saharawi population.
OBJECTIVE
Celiac disease (CD) is an enteropathic disorder very prevalent in Saharawi people. Our aim was to investigate the diagnostic accuracy of six human tissue transglutaminase (tTG) based ELISA tests in Saharawi CD patients.


METHODS
Fifty-two CD patients and 23 controls were selected from the Saharawi refugee camps in Tinduf. CD patients were divided into two groups according to their anti-endomysium (EmA) status: 41 EmA positive and 11 EmA negative. Sera from patients and controls were tested for human tTG using six commercial ELISA kits. We used receiver operating characteristics (ROC) curves and areas under the curve to compare the diagnostic accuracies of the six assays.


RESULTS
In general, there are differences in the sensitivity and specificity of the human tTG ELISA assays used. Diagnostic accuracy of tests was significantly improved by adjusting the cut-off thresholds according to ROC plot analysis; the correction of the cut-off with the employment of the ROC curve analysis modifies the decision limit in more than 50% in five of the six kits evaluated.


CONCLUSIONS
Some of the human tTG ELISAs used in this study have a diagnostic accuracy similar to EmA determination for diagnosis of CD in Saharawi people. However, it is necessary to select the assay with a higher sensitivity and specificity, and recalculate the cut-off threshold using samples from the referral population.
Fernández
Eloy
E
Biochemistry Service, Hospital de Cabueñes, Gijón, Asturias, Spain.
Riestra
Sabino
S
Rodrigo
Luis
L
Blanco
Carlos
C
López-Vázquez
Antonio
A
Fuentes
Dolores
D
Moreno
Maria
M
López-Larrea
Carlos
C
D000293:Adolescent; D000328:Adult; D000352:Africa, Northern; D002446:Celiac Disease / Q000097:blood / Q000175:diagnosis* / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D011503:Transglutaminases / Q000032:analysis / Q000097:blood*
D011933:Reagent Kits, Diagnostic; D011503:Transglutaminases