Big differences in primary care celiac disease serological markers request in Spain

Area of Science:

• Gastroenterology
• Clinical Immunology
• Public Health

Background:

• Celiac disease (CD) prevalence is rising globally, yet diagnosis rates remain suboptimal.
• General Practitioners (GPs) play a crucial role in initial CD screening through serology testing.
• Variability in diagnostic test utilization can impact patient outcomes and healthcare resource allocation.

Purpose of the Study:

• To analyze temporal and geographical variations in CD serology marker requests by GPs in Spain.
• To compare the utilization rates of tissue transglutaminase IgA antibodies (tTG-IgA) and deaminated peptide gliadine IgA antibodies (DGP-IgA).
• To identify regional disparities in CD diagnostic test ordering patterns.

Main Methods:

• A cross-sectional study involving Spanish clinical laboratories.
• Analysis of CD serology marker requests (tTG-IgA and DGP-IgA) from 2010, 2012, and 2014 across 15 autonomous communities.
• Calculation of test-utilization rates per 1000 inhabitants and the ratio of DGP-IgA to tTG-IgA requests.

Main Results:

• Requests for tTG-IgA significantly increased over the study period (3.99 to 5.90 per 1000 inhabitants).
• DGP-IgA utilization remained stable initially then decreased by 2014 (0.68 to 0.35 per 1000 inhabitants).
• The DGP-IgA/tTG-IgA ratio declined, with significant regional differences observed in 2014 (ranging from 0.01 to 0.57).

Conclusions:

• Significant inter-regional variability exists in CD serology marker utilization by GPs in Spain.
• The findings highlight the need for standardized testing protocols and inter-regional collaboration.
• Optimizing laboratory test use is essential for improving CD diagnosis and management.