The Performance of Nesfatin-1 in Distinguishing Irritable Bowel Syndrome Presenting Predominantly with Diarrhea from Celiac Disease

Abstract

Background: We hypothesized that nesfatin-1, an anti-inflammatory peptide, could be used as a non-invasive diagnostic tool in the identification of celiac disease (CD) and irritable bowel syndrome presenting predominantly with diarrhea (IBS-D). Methods: Thirty-five patients with IBS-D who met the Rome III criteria, 28 patients with celiac disease who met the diagnostic criteria of the Marsh-Oberhuber classification, and 30 age- and gender-matched healthy controls were included in this cross-sectional study. All subjects responded to the IBS Severity Scoring System (IBS-SSS) questionnaire that was used to determine pain severity, pain frequency, bloating, dissatisfaction with bowel habits, and life interference. Results: Nesfatin-1 levels were significantly higher in the CD group compared to the IBS-D group and healthy controls. Nesfatin-1 was also higher in the IBS-D group compared to controls. Nesfatin-1 levels were correlated with IBS-SSS (r = 0.884, p < 0.001), severity of abdominal pain and discomfort (r = 0.644, p < 0.001), and C-reactive protein concentrations (r = 0.303, p = 0.004). ROC curve analysis demonstrated that a cutoff value of > 98.1 pg/mL for nesfatin-1 could discriminate subjects with CD from those with IBS-D and also healthy controls with a sensitivity of 82% and a specificity of 80%. Conclusions: The results of this study show that subjects with CD have higher nesfatin-1 levels compared to those with IBS-D or to the healthy controls. Moreover, nesfatin-1 can discriminate subjects with CD from those with IBS-D and also healthy controls, with high sensitivity and specificity. Further studies with histopathological evaluation are required to clearly address the role of nesfatin-1 in the diagnosis of CD.