BackgroundCoeliac disease (CD) is common in patients with type 1 diabetes (T1D), but prevalence varies globally due to differing screening protocols. There have been substantial changes in screening guidelines over the past two decades.AimTo evaluate CD prevalence in patients with T1D, focusing on screening studies using antitissue transglutaminase (anti‐tTG) antibody.MethodsWe searched PubMed, Web of Science, Embase and Scopus for studies published up to 11 December 2023 using keywords related to CD and diabetes. We used random‐effects models for overall prevalence and all subgroups, with heterogeneity assessed using Cochran's Q test and the I2 statistic performed in STATA 18.ResultsWe included 106 articles involving 65,102 T1D patients across 40 countries. The pooled CD seroprevalence and confirmed CD prevalence were 9% (95% confidence interval, CI, 8%–10%) and 6% (95% CI 5%–7%), respectively. The prevalence was higher in females and children. Denmark, Saudi Arabia and Libya exhibited the highest prevalence (11%), followed by India and Egypt (10%). Belgium, France, Germany, South Africa and the United States had the lowest prevalence (2%). High‐income countries showed significantly a lower CD prevalence than middle‐income countries (p = 0.03). Meta‐regression based on the Human Development Index (HDI) indicated that countries with higher HDI have lower seroprevalence and confirmed CD prevalence.ConclusionApproximately 1 in 16 patients globally and 1 in 12 patients in Asia and the Middle East with T1D has CD. We suggest that all patients with T1D should be screened for CD.

中文翻译：

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荟萃分析： 1 型糖尿病乳糜泻的全球患病率


背景乳糜泻 （CD） 在 1 型糖尿病 （T1D） 患者中很常见，但由于筛查方案不同，全球患病率各不相同。在过去的二十年里，筛查指南发生了重大变化。目的评估 T1D 患者的 CD 患病率，重点是使用抗组织谷氨酰胺转移酶 （anti-tTG） 抗体的筛查研究。方法我们检索了 PubMed、Web of Science、Embase 和 Scopus，以查找截至 2023 年 12 月 11 日发表的与 CD 和糖尿病相关的关键词的研究。我们对总体患病率和所有亚组使用随机效应模型，使用 Cochran Q 检验和 STATA 18 中进行的 I2 统计量评估异质性。合并的 CD 血清阳性率和确诊的 CD 患病率分别为 9% （95% 置信区间，CI，8%-10%） 和 6% （95% CI 5%-7%）。女性和儿童的患病率较高。丹麦、沙特阿拉伯和利比亚的患病率最高 （11%），其次是印度和埃及 （10%）。比利时、法国、德国、南非和美国的患病率最低 （2%）。高收入国家的 CD 患病率明显低于中等收入国家 （p = 0.03）。基于人类发展指数 （HDI） 的 Meta 回归分析表明，HDI 较高的国家血清阳性率较低，确诊的 CD 患病率较低。结论全球约 16 名患者中有 1 名患有 CD，亚洲和中东每 12 名患者中约有 1 名患有 CD。我们建议所有 T1D 患者都应接受 CD 筛查。