Evaluation of Serum Amyloid A Levels in Celiac Disease

Objective: In celiac disease (CD), gluten intake triggers the release of T-cell-derived pro-inflammatory cytokines leading to an increase in the level of serum amyloid A (SAA). To confirm inflammation caused by CD in patients, SAA level is expected to be a better biomarker candidate than C-reactive protein (CRP). This study investigated the relationship between clinical and biochemical variables used in the follow-up of CD patients and SAA levels. Methods: This study is a cross-sectional observational study which was conducted in patients who presented with a diagnosis of CD in a university hospital between June 1, 2019 and December 1, 2019. Patients were categorized into two groups based on the presence of tissue transglutaminase (tTG) immunoglobulin. Statistical analysis of data was performed by considering the age, gender, duration of the disease, frequency of compliance with a gluten-free diet, body mass index, and some laboratory parameters [vitamin D (VD), tTG IgA-IgG, CRP] taken simultaneously with the SAA levels. Results: A total of 90 patients, 28 (31.1%) antibody positive and 62 (68.9%) antibody negative, were included in the study. We found out that there was a statistically significant difference between between SAA level, VD levels, and the duration of CD in the patients (p=0.03 and p=0.009, respectively). Conclusion: VD levels <20 ng/mL, in advanced age, and duration of CD >5 years should be evaluated in the high-risk groups in terms of high SAA levels. If there is a persistent increase in SAA level during follow-up visits of patients with CD, they should be evaluated in terms of complications caused by the chronic inflammation.