Prevalence and Factors Associated with Celiac Disease in High-Risk Patients with Functional Gastrointestinal Disorders
Authors: Syam Ari Fahrial , Utari Amanda Pitarini , Hasanah Nur Hamidah , Rizky Almaarif , Abdullah Murdani 
Published: January 2024

Celiac disease (CD) is an autoimmune disease of the small intestine triggered by the consumption of gluten-containing foods in individuals with a genetic predisposition. CD was a rare disease until 20 years ago, when the prevalence increased. Currently, there is no data on the prevalence of CD in high-risk adult populations in Indonesia, even though there is a trend of increasing gluten consumption. Therefore, basic research is needed to determine the magnitude of CD in high-risk adult patients in Indonesia while identifying clinical signs/symptoms, illness history, and lifestyle to determine factors associated with CD in Indonesia. This study is an observational study with a cross-sectional method.Two hundred eighty-three3 patients who fulfilled the selection and signed the informed consent were recruited from the gastroenterology clinic of Dr. Cipto Mangunkusumo General Hospital. Patients were asked to fill out a celiac disease-related questionnaire and then given anthropometry measurement and blood test for serologic examination with ELISA, consisting of IgA anti-tissue transglutaminase (anti-TTG) and IgG anti-deaminated gliadin peptide (anti-DGP). Statistical analysis was performed using Chi-square and Multivariate logistic regression tests with SPSS software ver. 26. Statistical test differences were considered significant if the p-values were < 0.05. Eight of 283 patients are serologically confirmed with CD (2,83%). On bivariate analysis, the significant variables are age (p < 0,05), constipation (p < 0,05) and history of autoimmune disease (p < 0,05). On multivariate analysis, the only significant variable is the history of autoimmune disease (p < 0,05). This study concluded that the prevalence of CD in high-risk patients with functional gastrointestinal disorder at Dr. Cipto Mangunkusumo Hospital is relatively high (2.83%). CD-associated factors are age, constipation, and history of autoimmune disease in patients. On simultaneous interaction between these factors, autoimmune is the only significant variable associated with CD.

Author Summary

Gluten consumption is increasing globally, yet there is no data on the prevalence of CD in high-risk adult populations in Indonesia. Therefore, a study is needed to determine the prevalence of CD in high-risk adult patients in Indonesia while identifying clinical signs and symptoms, patients’ disease history, and lifestyle to determine factors influencing the incidence of CD in Indonesia. We collected data through questionnaires, anthropometry, and lab examinations for IgA anti-TTG and IgG anti-DGP examinations. Out of 283 patients, eight patients (2.83%) are serologically confirmed with CD. On bivariate analysis, age, constipation, and history of autoimmune disease are the significant factors associated with CD; on multivariate analysis, only history of autoimmune disease is significant. This study found that the prevalence of CD in high-risk patients with functional gastrointestinal disorder is relatively high (2.83%) compared to another similar study, which stated 0,61%; its associated factors are age, constipation, and history of autoimmune disease.