Meta-analysis: yield of diagnostic tests for coeliac disease in dyspepsia.
BACKGROUND
The prevalence of coeliac disease (CD) may be increased in individuals with dyspepsia, but evidence is conflicting.


OBJECTIVE
To conduct a systematic review and meta-analysis of studies reporting prevalence of CD in dyspepsia.


METHODS
MEDLINE, EMBASE, and CINAHL were searched up to February 2009. Case series and case-control studies applying serological tests and/or distal duodenal biopsy for CD to unselected adults with dyspepsia were eligible. Prevalence of positive coeliac serology and biopsy-proven CD were pooled for all studies and compared between cases and controls using an odds ratio (OR) and 95% confidence interval (CI).


RESULTS
Fifteen studies were identified. Prevalence of positive coeliac serology was higher in cases with dyspepsia (7.9%) compared with controls (3.9%), but not significantly so (OR for positive endomysial antibodies or tissue transglutaminase 1.89; 95% CI 0.90-3.99). Prevalence of biopsy-proven CD following positive serology was also higher (3.2% in cases vs. 1.3% in controls), but again this was not statistically significant (OR 2.85; 95% CI 0.60-13.38). Prevalence of biopsy-proven CD was 1% in ten studies performing duodenal biopsy first-line.


CONCLUSIONS
Prevalence of biopsy-proven CD in subjects with dyspepsia was 1% and was higher than in controls, although this difference was not statistically significant.
Gastroenterology Division, McMaster University, Health Sciences Centre, Hamilton, ON, Canada. alexf12399@yahoo.com
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Ford
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Ching
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Moayyedi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002446:Celiac Disease / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology*; D003955:Diagnostic Tests, Routine; D004415:Dyspepsia / Q000453:epidemiology / Q000276:immunology*; D016021:Epidemiologic Studies; D006801:Humans; D008875:Middle Aged; D055815:Young Adult
D000906:Antibodies; D015415:Biomarkers