Coeliac disease in China, a field waiting for exploration

ABSTRACT

Background: no systematic studies on the prevalence ofcoeliac disease (CD) have been reported from China. In westernpopulations CD is more common in patients with insulin dependentdiabetes mellitus (IDDM) and in diarrhoea-predominant irritablebowel syndrome (D-IBS). We have screened patients withthese conditions presenting to the outpatient department of alarge hospital of “Traditional Chinese Medicine” (TCM) in Nanjing,Jiangsu province, P.R. China.Methods: we tested sera of 78 unrelated Han Chinese patients(5 IDDM and 73 D-IBS), using ELISA serological tests forIgG anti-gliadin antibodies (IgG-AGA) and IgA anti-tissue transglutaminaseantibodies (IgA-tTG).Results: six out of 78 patients (7.7%) were positive for IgGAGA(two men and four women) and two (2.6%) were positive forIgA-tTGs. One of the latter patients was negative for IgG-AGA.Besides, one patient had a dubious IgA-tTG antibody and a positiveIgG-AGA. None of the six patients agreed to undergo duodenalbiopsy. Two out of these six patients followed a gluten-freediet for one year. In one patient the diarrhoea ceased and hisbody weight increased. Another stopped losing weight.Conclusions: this study previously published as a letter inGUT (Wu J, Xia B, von Blomberg BME, Zhao C, Yang XW, CrusiusJBA, Peña AS. Coeliac disease: emerging in China? Gut2010; 59(3): 418-9) demonstrated that CD may exist in theJiangsu province of P.R. China. The present article draws attentionto the difficulties of following a standard protocol in Chinasuch as established in western countries and highlights importantfactors less well known in the west in relation to the developmentof CD in China. Wheat production became significant in Chinabetween 1600 and 1300 B.C. After the Han dynasty (500-200B.C.), wheat was one of the main cereals in China. One the majorwheat fields in China is located in the Jiangsu province where theresearch for this article was performed...(AU)