Journal title
عنوان نشریه
Technology and Research Information System
Literature & Humanities
http://newresearch.medilam.ac.ir
1
admin
doi
fa
jalali
1398
2
1
gregorian
2019
5
1
2
1
online
1
fulltext
fa
اپیدمیولوژی سلیاک در بیماران سندرم روده ی تحریک پذیر ایران: یک مطالعه ی مرور سیستماتیک و متاآنالیز
Epidemiology of celiac disease in irritable bowel syndrome patients in Iran: a systematic review and met analysis study
عمومي
General
مقطعی (Cross sectional)
Cross sectional
<span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">زمینه: با توجه به مشابهت علایم بیماری سلیاک (</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">CD</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">) و سندرم روده تحریک پذیر</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">(IBS)</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">، هر دو در تشخیص افتراقی دیگری قرار می گیرند. لذا </span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">مطالعه حاضر</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">با هدف بررسی اپیدمیولوژیک </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">CD</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> در بیماران </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">IBS</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> ایران با استفاده از روش های مرور سیستماتیک و متاآنالیز انجام شده است.</span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"></span></span><br>
<span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">روش کار:</span></span><br>
<span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">مطالعه کنون براساس گایدلاین </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">PRISMA</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> انجام</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شد.</span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> پایگاه داده های آنلاین بین المللی و ملی (</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">Scopus</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">PubMed</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">Science Direct</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> ، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">Cochrane</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> ، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">Embase</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">Web of Science</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">Magiran </span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">Iranmedex</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">SID</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">Medlib </span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">IranDoc</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> و هم چنین موتورجستجوی </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">Google Scholar</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">) به صورت سیستماتیک جستجو شدند.</span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> برای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">ارزیابی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">ناهمگنی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">مطالعات</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">از</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">آزمون کوکران</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شاخص </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">I<sup>2</sup></span></span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">استفاده</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شد. انالیز داده ها براساس مدل اثرات تصادفی انجام شد. آنالیز آماری با استفاده از </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">Comprehensive Meta-Analysis Software</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> انجام شد</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">.</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> سطح معنا داری آزمون ها 0.05 </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">P<</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> در نظر گرفته شد.</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;"></span></span></span><br>
<span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">نتایج:</span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> 11 مطالعه وارد متاآنالیز شدند. میانگین سنی بیماران مبتلا به </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">IBS</span></span></span> <span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">33.14</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;"> (95% CI: </span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">31.33-34.95</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">)</span></span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">سال برآورد گردید.</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شیوع </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">CD</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> در بیماران 2367 بیمار </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">IBS</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> ایرانی </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">6.13</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">% (95% CI</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">: 4.11-6.05</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">)</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> براورد گردید. </span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">نسبت زن و مرد </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">CD</span></span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">(</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">OR= 1.69 (95%CI: 0.86-3.32, P=0.127)</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">) بود. </span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شیوع سرولوژیک </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">Anti tTG-IgA</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> (11 مطالعه با حجم 29.1 بیمار </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">IBS</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">) و </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">AGA-IgG</span></span></span> <span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">CD</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> (4 مطالعه با 936 بیمار </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">IBS</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">) </span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">به ترتیب </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">5.35</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">% (95% CI</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">: 3.60-7.89</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">)</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> و</span></span> <span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">6.35</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">% (95% CI</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">: 2.05-18.03</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">)</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> برآورد گردید. </span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شیوع</span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> علائم بالینی </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">CD</span></span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">در میان بیماران </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">IBS</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> به صورت اسهال غالب</span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">(</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">IBS-D</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">)</span></span> <span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">[47.78</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">% (95% CI: </span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">22.46-74.43</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">)]</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> ، یبوست غالب</span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">(</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">IBS-C</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">)</span></span> <span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">[</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">17.34</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">% (95% CI: </span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">9.17-30.35</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">)]</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> و الترنیتیو اسهال و یبوست </span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">(</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">IBS-M</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">)</span></span> <span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">[</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">27.84</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">% (95% CI: </span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">11.57-53.23</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">)]</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> بود. </span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">براساس طبقه بندی </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">Marsh</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">، شیوع استیج های 1، 2 و 3 سلیاک به ترتیب </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">30.89</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">% (95% CI: </span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">13.25-56.68</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">)</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">، </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">36.56</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">% (95% CI: </span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">21.74-54.45</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">)</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> و </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">52.82</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">% (95% CI: </span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">14.48-88.13</span></span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">)</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> برآورد گردید.</span></span><br>
<span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">نتیجه گیری: </span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شیوع </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">CD</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> در بیماران </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">IBS</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> ایران بالا می باشد و نسبت به برآوردهای جهانی بالاتر می باشد. به نظر می رسد بررسی تمام بیماران </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">IBS</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> از نظر </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">CD</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> ضروری می باشد.</span></span>
<strong>Aim</strong>: The present study was conducted to evaluate the prevalence, clinical symptoms and pathological findings of celiac disease (CD) in IBS patients in Iran.<br>
<strong>Background:</strong> Several studies show high prevalence of CD in IBS patients, but the results are contradictory<br>
<strong>Methods</strong>: The present study was conducted based on PRISMA protocol. The search was done using national and international online databases including Scopus, PubMed, Science Direct, Cochrane Library, Embase, Web of Science, Google Scholar search engine and Iranian databases.<br>
<strong>Results</strong>: The pooled prevalence of CD in 2367 Iranian IBS patients was estimated to be 6.13% (95%CI: 4.11-6.05). The CD female-to-male ratio was: OR = 1.69 (95%CI: 0.86-3.32, P = 0.127). The serological prevalence of Anti tTG-IgA (11 studies with 2901 IBS patients) and AGA-IgG CD (4 studies with 936 IBS patients) was estimated to be 5.35% (95%CI: 3.60-7.89) and 6.35% (95% CI: 2.05-18.03), respectively. The clinical symptoms of CD among IBS patients included predominant diarrhea (47.78% [95%CI: 22.46-74.43]), predominant constipation (17.34% [95%CI: 9.17-30.35]), and alternative diarrhea and constipation (27.84% [95%CI: 11.57-53.23]). According to pathological findings based on Marsh classification, the prevalence of CD at stages 1, 2 and 3 were 30.89% (95%CI: 13.25-56.68), 36.56% (95%CI: 21.74-54.45) and 52.82% (95% CI: 14.48-88.13), respectively.<br>
<strong>Conclusion</strong>:<em> CD prevalence in Iranian IBS patients is higher than global estimates. It seems that examination of all IBS patients in terms of CD is necessary</em>
بیماری سلیاک, سندرم روده تحریک پذیر
Celiac disease, Irritable bowel syndrome, Meta-Analysis, Iran.
0
0
http://newresearch.medilam.ac.ir/browse.php?a_code=A-10-2456-16&slc_lang=fa&sid=1
Milad
Azami
میلاد
اعظمی
milad98azami@gmail.com
4490248474
100319475328460026533
Yes
Ilam University of Medical Sciences, Ilam, Iran
دانشگاه علوم پزشکی ایلام، ایلام، ایران