Predictive Value of the Intestinal Free Fatty Acid Binding Protein in Celiac Disease
Yıl: 2022 Cilt: 13 Sayı: 1 Sayfa Aralığı: 30 - 35 Metin Dili: İngilizce DOI: 10.31067/acusaglik.979140 İndeks Tarihi: 28-02-2022
Predictive Value of the Intestinal Free Fatty Acid Binding Protein in Celiac Disease
Öz: Purpose: Non-invasive tests used in the screening and follow-up of celiac disease (CD) are currently below expectations because they show false negatives/positives and are not always correlated with duodenal histology. We aimed to investigate the predictive value of intestinal free fatty acid binding protein (FABP-I) which can easily be released into the circulation in the presence of enterocyte damage in a short time in CD. Methods: This study included 59 patients with CD who were not on gluten free diet (GFD)(n=24) and who were on GFD(n=35) and 52 healthy controls. Demographic variables, complete blood count, ferritin, vitamin D, calcium, phosphorus, vitamin B12, prothrombin time, INR, and serum FABP-I levels were recorded for all groups. Results: There was no difference between the groups in terms of complete blood count, ferritin, calcium, phosphorus, vitamin B12, prothrombin time and INR (all p>0.05). Mean serum FABP-I was determined as 499.2±33.3 ng/L for patients with CD who were not on GFD and as 487.7±48.0 ng/L for who were on GFD, and these values were significantly higher when compared to the healthy controls 432.2±63.8 ng/L(p<0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of FABP-I for a cut-off value of 456.8 ng/L were 84.7%, 69.2%, 10.2% and 61.5%, respectively(AUC=0.785). Conclusion: This study has shown that FABP-I can serve as a non-invasive predictive marker for CD diagnosis. Overlooked diagnosis in serology-negative patients and false serology positivity for reasons other than CD will be prevented with its use in clinical practice since FABP-I directly reflects intestinal damage.
Anahtar Kelime: İntestinal Serbest Yağ Aside Bağlayan Proteinin Çölyak Hastalığındaki Prediktif Değeri
Öz: Amaç: Çölyak hastalığının tarama ve takibinde kullanılan non invaziv testler, yalancı negatiflik/ pozitiflik göstermeleri ve duodenal histoloji ile her zaman korele olmamaları nedeniyle günümüzde beklentinin altında kalmaktadır. Son çalışmalar, çölyak hastalığındaki bu eksikliği tamamlamak için barsak epitelyal hasarını gösteren direk belirteçler üzerine yoğunlaşmaktadır. İntestinal serbest yağ asidi bağlayan protein (FABP-I); suda eriyen küçük bir protein olduğu için enterosit hasarını takiben kısa süre içinde dolaşıma salınır. Çalışmamızda FABP-I’nın çölyak hastalığındaki prediktif değerini araştırmayı amaçladık. Yöntem: Çalışmaya glutensiz diyete (GDF) uyum göstermeyen (n=24) ve GFD’ ye uyum gösteren (n=35) 59 çölyak hastası ve 52 sağlıklı kontrol dahil edildi. Tüm gruplarda demografik veriler ve tam kan sayımı, ferritin, vitamin D, kalsiyum, fosfor, vitamin B12, protrombin zamanı, INR ve serum FABP-I düzeyleri kaydedildi. Bulgular: Tam kan sayımı, ferritin, kalsiyum, fosfor, vitamin B12, protrombin zamanı, INR düzeyleri açısından gruplar arasında farklılık görülmedi (tüm p>0.05). Ortalama serum FABP-I düzeyi GFD uyumsuz çölyak hastalarında 499.2±33.3 ng/L, GFD uyumlu çölyak hastalarında 487.7±48.0 ng/L saptandı ve bu sonuçlar sağlıklı kontrole göre (432.2±63.8 ng/L) anlamlı derecede yüksek bulundu (p<0.001). Serum FABP-I için cut-off değeri 456.8 ng/L alındığında, FABP-I’nin çölyak hastalığı tanısında duyarlılığı, özgüllüğü, pozitif ve negatif prediktif değeri sırasıyla %84.7, %69.2, %10.2 ve %61.5 bulundu (AUC=0.785). Sonuç: Serum FABP-I, çölyak hastalığı tanısında direkt barsak hasarını gösteren non invaziv prediktif bir belirteçtir. FABPI’nın klinik kullanıma girmesiyle seronegatif hastalarda tanının gözden kaçması ve çölyak hastalığı dışındaki nedenlere bağlı serolojinin yanlış pozitif olduğu durumlarda tanıdaki zorluklar önlenmiş olacaktır.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Vreugdenhil AC, Wolters VM, Adriaanse MP, et al. Additional value of serum I-FABP levels for evaluating celiac disease activity inchildren. Scand J Gastroenterol. 2011;46:1435-41. DOI:10.3109/00365521.201 1.627447
- 2. Adriaanse MP, Tack GJ, Passos VL, et al. Serum I-FABP as marker for enterocyte damage in coeliac disease and its relation to villous atrophy and circulating autoantibodies. Aliment Pharmacol Ther. 2013;37:482-90. DOI:10.1111/apt.12194.
- 3. Oberhuber G, Granditsch G, Vogelsang H. The histopathology of coeliac disease: time for a standardized report scheme for pathologists. Eur J Gastroenterol Hepatol. 1999;11:1185-94. DOI: 10.1097/00042737-199910000-00019
- 4. Rubio TA, Hill ID, Kelly CP, et al. ACG clinical guidelines: Diagnosis and management of celiac disease. Am J Gastroenterol. 2013;108:656- 76. DOI: 10.1038/ajg.2013.79
- 5. Volta U, Fabbri A, Parisi C, et al. Old and new serological test for celiac disease screening. Expert Rev Gastroenterol Hepatol. 2010;4:31-5. DOI: 10.1586/egh.09.66
- 6. Lewis NR, Scott BB. Meta-analysis: deamidated gliadin peptide antibody and tissue transglutaminase antibody compared as screening tests for coeliac disease. Aliment Pharmacol Ther. 2010;31:73-81. DOI: 10.1111/j.1365-2036.2009.04110.x.
- 7. Adriaanse MPM, Mubarak A, Riedl RG, et al. Progress towards noninvasive diagnosis and follow-up of celiac disease in children; a prospective multicentre study to the usefulness of plasma I-FABP. Sci Rep. 2017;7:8671. DOI: 10.1038/s41598-017-07242-4.
- 8. Ho SSC, Keenan JI, Day AS. The Role of Gastrointestinal-Related Fatty Acid-Binding Proteins as Biomarkers in Gastrointestinal Diseases. Dig Dis Sci. 2020;65:376-90. DOI: 10.1007/s10620-019-05841-x
- 9. Not T, Ziberna F, Vatta S, et al. Cryptic genetic gluten intolerance revealed by intestinal antitransglutaminase antibodies and response to gluten-free diet. Gut. 2011;6011:1487-93. DOI: 10.1136/ gut.2010.232900
- 10. Salardi S, Volta U, Zucchini S, et al. Prevalence of celiac disease in children with type 1 diabetes mellitus increased in the mid-1990s: an 18-year longitudinal study based on anti-endomysial antibodies. J Pediatr Gastroenterol Nutr. 2008;46:612-4. DOI: 10.1097/ MPG.0b013e31815d697e.
- 11. Shamaly H, Hartman C, Pollack S, et al. Tissue transglutaminase antibodies are a useful serological marker for the diagnosis of celiac disease in patients with Down syndrome. J Pediatr Gastroenterol Nutr. 2007;44:583-6. DOI: 10.1097/MPG.0b013e3180320679.
- 12. Sardy M, Csikos M, Geisen C, et al. Tissue transglutaminase ELISA positivity in autoimmune disease independent of glutensensitive disease. Clin Chim Acta. 2007;376:126-35. DOI: 10.1016/j. cca.2006.08.006
- 13. Sood A, Khurana MS, Mahajan R, et al. Prevalence and clinical significance of IgA anti-tissue transglutaminase antibodies in patients with chronic liver disease. J Gastroenterol Hepatol. 2017;32:446-50. DOI: 10.1111/jgh.13474
- 14. Oldenburger IB, Wolters VM, Kardol-Hoefnagel T, et al. Serum intestinal fatty acid-binding protein in the noninvasive diagnosis of celiac disease. APMIS. 2018;126:186-90. DOI: 10.1111/apm.12800
- 15. Dipper CR, Maitra S, Thomas R, et al. Anti-tissue transglutaminase antibodies in the follow-up of adult coeliac disease. Aliment Parmacol Ther. 2009;30:236-244. DOI: 10.1111/j.1365-2036.2009.04039.x
- 16. Gidrewicz D, Trevenen CL, Lyon M, et al. Normalization time of celiac serology in children on a gluten-free diet. J Pediatr Gastroenterol Nutr. 2017;64:362-7. DOI: 10.1097/MPG.0000000000001270
- 17. Al-Toma A, Volta U, Auricchio R, et al. European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterol J. 2019;7:583-613. DOI: 10.1177/2050640619844125
| APA | GÖKÇEN P, Cakmak E, ADALI G, DOĞAN H, ÖZER H, Ozturk O, DOGANAY H, ozdil k (2022). Predictive Value of the Intestinal Free Fatty Acid Binding Protein in Celiac Disease. , 30 - 35. 10.31067/acusaglik.979140 |
| Chicago | GÖKÇEN PINAR,Cakmak Erol,ADALI GUPSE,DOĞAN Halef Okan,ÖZER Hatice,Ozturk Oguzhan,DOGANAY HAMDI LEVENT,ozdil kamil Predictive Value of the Intestinal Free Fatty Acid Binding Protein in Celiac Disease. (2022): 30 - 35. 10.31067/acusaglik.979140 |
| MLA | GÖKÇEN PINAR,Cakmak Erol,ADALI GUPSE,DOĞAN Halef Okan,ÖZER Hatice,Ozturk Oguzhan,DOGANAY HAMDI LEVENT,ozdil kamil Predictive Value of the Intestinal Free Fatty Acid Binding Protein in Celiac Disease. , 2022, ss.30 - 35. 10.31067/acusaglik.979140 |
| AMA | GÖKÇEN P,Cakmak E,ADALI G,DOĞAN H,ÖZER H,Ozturk O,DOGANAY H,ozdil k Predictive Value of the Intestinal Free Fatty Acid Binding Protein in Celiac Disease. . 2022; 30 - 35. 10.31067/acusaglik.979140 |
| Vancouver | GÖKÇEN P,Cakmak E,ADALI G,DOĞAN H,ÖZER H,Ozturk O,DOGANAY H,ozdil k Predictive Value of the Intestinal Free Fatty Acid Binding Protein in Celiac Disease. . 2022; 30 - 35. 10.31067/acusaglik.979140 |
| IEEE | GÖKÇEN P,Cakmak E,ADALI G,DOĞAN H,ÖZER H,Ozturk O,DOGANAY H,ozdil k "Predictive Value of the Intestinal Free Fatty Acid Binding Protein in Celiac Disease." , ss.30 - 35, 2022. 10.31067/acusaglik.979140 |
| ISNAD | GÖKÇEN, PINAR vd. "Predictive Value of the Intestinal Free Fatty Acid Binding Protein in Celiac Disease". (2022), 30-35. https://doi.org/10.31067/acusaglik.979140 |
| APA | GÖKÇEN P, Cakmak E, ADALI G, DOĞAN H, ÖZER H, Ozturk O, DOGANAY H, ozdil k (2022). Predictive Value of the Intestinal Free Fatty Acid Binding Protein in Celiac Disease. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 13(1), 30 - 35. 10.31067/acusaglik.979140 |
| Chicago | GÖKÇEN PINAR,Cakmak Erol,ADALI GUPSE,DOĞAN Halef Okan,ÖZER Hatice,Ozturk Oguzhan,DOGANAY HAMDI LEVENT,ozdil kamil Predictive Value of the Intestinal Free Fatty Acid Binding Protein in Celiac Disease. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 13, no.1 (2022): 30 - 35. 10.31067/acusaglik.979140 |
| MLA | GÖKÇEN PINAR,Cakmak Erol,ADALI GUPSE,DOĞAN Halef Okan,ÖZER Hatice,Ozturk Oguzhan,DOGANAY HAMDI LEVENT,ozdil kamil Predictive Value of the Intestinal Free Fatty Acid Binding Protein in Celiac Disease. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, vol.13, no.1, 2022, ss.30 - 35. 10.31067/acusaglik.979140 |
| AMA | GÖKÇEN P,Cakmak E,ADALI G,DOĞAN H,ÖZER H,Ozturk O,DOGANAY H,ozdil k Predictive Value of the Intestinal Free Fatty Acid Binding Protein in Celiac Disease. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2022; 13(1): 30 - 35. 10.31067/acusaglik.979140 |
| Vancouver | GÖKÇEN P,Cakmak E,ADALI G,DOĞAN H,ÖZER H,Ozturk O,DOGANAY H,ozdil k Predictive Value of the Intestinal Free Fatty Acid Binding Protein in Celiac Disease. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2022; 13(1): 30 - 35. 10.31067/acusaglik.979140 |
| IEEE | GÖKÇEN P,Cakmak E,ADALI G,DOĞAN H,ÖZER H,Ozturk O,DOGANAY H,ozdil k "Predictive Value of the Intestinal Free Fatty Acid Binding Protein in Celiac Disease." Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 13, ss.30 - 35, 2022. 10.31067/acusaglik.979140 |
| ISNAD | GÖKÇEN, PINAR vd. "Predictive Value of the Intestinal Free Fatty Acid Binding Protein in Celiac Disease". Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 13/1 (2022), 30-35. https://doi.org/10.31067/acusaglik.979140 |
