Meltem GÜMÜŞ, Alaaddin YORULMAZ, Esra KİLİM, Reyhan GÜMÜŞTEKİN, Anna Carina ERGANİ, Halil EMİROĞLU

Çölyak Hastalığının Tanı ve Takibinde Biyobelirteçlerin Önemi

Amaç: Çalışmamızda çölyak hastalığı tanılı çocuklarda tedavi öncesi ve sonrası inflamasyon temelli biyobelirteçlerin klinik önemi, tanısal yetenekleri, ilişkileri ve korelasyonlarını araştırmayı amaçladık. Yöntemler: Bu çalışma, Ocak 2011- Ocak 2023 tarihleri arasında Selçuk Üniversitesi Çocuk Gastroenteroloji bölümünde tanı alan ve takip edilen hasta dosyalarının retrospektif olarak değerlendirilmesi ile gerçekleştirilmiştir. Avrupa Pediatrik Gastroenteroloji, Hepatoloji ve Beslenme topluluğunun kriterlerine göre tanı konulan 202 Çölyak hastası ve 160 sağlıklı kontrol grubu ile çalışma tamamlanmıştır. Hastaların tamamında klinik ve laboratuvar olarak şüphe duyulması halinde bakılan Doku Transglutaminaz Antikor (Anti-TTG) ve Anti Endomisyum (EMA) düzeyi gibi serolojik testlerinde pozitiflik olan ve endoskopik doku örneğinin histopatolojik incelemesinde ÇH ile uyumlu bulgular olma şartı arandı. Bulgular: Hasta grubunda 122 (%56.7) kız, 80 (%54.4) erkek ve kontrol grubunda ise 93 kız (%43.3), 67 erkek (%45.6) idi. En sık karşılaşılan intestinal başvuru yakınması 49 (%22,3) idi. Hastalara tanı sonrası glutensiz diyet tedavisi başlandı. Hastaların tanı anı, diyet sonrası 6. ay kontrol değerleri ve sağlıklı kontrol hastaların değerleri karşılaştırıldı. Yapılan korelasyon analizinde NLO, RPO, RLO seviyeleri ile yaş, vücut ağırlığı ve boy arasında zayıf pozitif korelasyon tespit edildi. Çölyak hastalarının tanısal ek destek düzeyini değerlendirmek amacı ile Hematolojik biyobelirteçler için ROC eğrisi kullanılmıştır. Sonuç: Glutensiz diyet sonrası semptomlar gerilemekte ve daha ciddi çölyak ilişkili hasarların gelişmesi önlenebilmektedir. Çölyak hastaların takipte diyet uyumunu belirlemek için birçok inflamatuar durumda kullanılan ve rutin hemogram parametrelerinden elde edilen NLO, RLO, PLO, Sİİ, HRO ve PNİ formüllerinin kullanılabileceğini düşündürmektedir.

Anahtar Kelimeler:

çölyak hastalığı, çocuklar, biyobelirteç, glutensiz diyet

The Importance of Biomarkers in the Diagnosis and Follow-Up of the Celiac Disease

Aim: In the present study, the purpose was to investigate the clinical significance, diagnostic capabilities, relationships, and correlations of inflammation-based biomarkers before and after treatment in children with Celiac Disease. Methods: The study was conducted by retrospectively evaluating the files of patients who were diagnosed and followed up in the Department of Pediatric Gastroenterology of Selçuk University between January 2011 and January 2023. The study was completed with 202 Celiac Disease patients who were diagnosed according to the criteria of the European Pediatric Gastroenterology, Hepatology, and Nutrition Community and 160 healthy follow-ups. In case of clinical or laboratory suspicion, serological tests such as positive Tissue Transglutaminase Antibody and Anti-Endomysium values and the histopathological examination of the endoscopic tissue sample findings consistent with Celiac Disease were evaluated. Results: There were 122 (56.7%) girls and 80 (54.4%) boys in the patient group and 93 (43.3%) girls and 67 (45.6%) boys in the control group. The most common intestinal complaint was abdominal pain in 49 (22.3%) patients. Gluten-free diet treatment was started after the diagnosis. The values of the patients at the time of diagnosis, in the 6th month after the diet, and the values of healthy control patients were compared. A weak and positive correlation was found between NLR, RPO, RLO levels, and age, body weight, and height in the correlation analysis. The ROC curve for hematological biomarkers was used to evaluate the level of additional diagnostic support in Celiac Disease patients. Conclusion: After a gluten-free diet, symptoms regress, and the development of more serious celiac-related damage can be prevented. This suggests that NLR, RLR, PLO, SII, HRO, and PNI formulas, which are used in many inflammatory conditions and obtained from routine hemogram parameters, can be used to determine dietary compliance in Celiac Disease patients during their follow-ups.

Keywords:

celiac disease, chıldren, biomarkers, gluten free diet,

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