Objective Potential coeliac disease (PCD) is characterised by positive serological and genetic markers of coeliac disease with architecturally preserved duodenal mucosa. The clinical outcomes and rates of progression to overt coeliac disease in patients with PCD remain uncertain. In this systematic review and meta-analysis, we aimed to evaluate the clinical outcomes of patients with PCD. Design We searched Medline, Embase, Scopus and Cochrane Library from 1991 through May 2024 to identify studies evaluating the clinical outcomes of patients with PCD. The progression rates to villous atrophy, seroconversion and response to a gluten-free diet (GFD) were analysed. A random-effect meta-analysis was performed, and the results were reported as pooled proportions with 95% CIs. Results Seventeen studies comprising 1010 patients with PCD were included in the final analyses. The pooled prevalence of PCD among patients with suspected coeliac disease was 16% (95% CI 10% to 22%). The duration of follow-up in most of the studies was at least 1 year, with follow-up periods within individual studies ranging from 5 months to 13 years. During follow-up, 33% (95% CI 18% to 48%; I2=96.4%) of patients with PCD on a gluten-containing diet developed villous atrophy, and 33% (95% CI 17% to 48%; I2=93.0%) had normalisation of serology. Among those who adhered to a GFD, 88% (95% CI 79% to 97%; I2=93.2%) reported symptomatic improvement. Conclusion Almost a third of patients with PCD develop villous atrophy over time, whereas a similar proportion experience normalisation of serology despite a gluten-containing diet. Most symptomatic patients benefit from a GFD. These findings highlight the importance of structured follow-up and individualised management for patients with PCD. Data are available upon reasonable request.

中文翻译：

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潜在乳糜泻的临床结局：系统评价和荟萃分析


目的 潜在乳糜泻 （PCD） 的特征是乳糜泻的血清学和遗传标志物阳性，但十二指肠粘膜结构保留。PCD 患者的临床结局和进展为显性乳糜泻的速率仍不确定。在本系统评价和荟萃分析中，我们旨在评估 PCD 患者的临床结局。设计 我们检索了 1991年至 2024 年 5 月的 Medline、Embase、Scopus 和 Cochrane Library，以确定评估 PCD 患者临床结局的研究。分析了绒毛萎缩的进展率、血清转化和对无麸质饮食 （GFD） 的反应。进行了一项随机效应荟萃分析，结果报告为具有 95% CI 的合并比例。结果 最终分析纳入 17 项研究，包括 1010 例 PCD 患者。疑似乳糜泻患者的 PCD 汇总患病率为 16% （95% CI 10%-22%）。大多数研究的随访持续时间至少为 1 年，个别研究的随访期从 5 个月到 13 年不等。在随访期间，33% （95% CI 18% 至 48%;I2=96.4%）接受含麸质饮食的 PCD 患者出现绒毛萎缩，33% （95% CI 17% 至 48%;I2=93.0%） 血清学正常。在坚持 GFD 的患者中，88% （95% CI 79% 至 97%;I2=93.2%） 报告症状改善。结论 近 3 的 PCD 患者随着时间的推移发展为绒毛状萎缩，而相似比例的患者尽管有含麸质饮食，但血清学检查正常。大多数有症状的患者受益于 GFD。这些发现强调了结构化随访和个体化管理对 PCD 患者的重要性。 数据可根据合理要求提供。