{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T23:55:31Z","timestamp":1781913331269,"version":"3.54.5"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pancreatic exocrine insufficiency (PEI) is seen in primary pancreatic disease but has also been seen in extrapancreatic conditions including celiac disease (CeD). The symptoms of PEI and CeD often overlap, which makes diagnostics challenging. In this systematic review and meta\u2010analysis, we aimed to investigate the prevalence of PEI in CeD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>With the assistance of a professional librarian, we searched five databases: PubMed, Embase, Cochrane, Web of Science Core Collection, and Google Scholar, up until October 21, 2024. The pooled prevalence of PEI in biopsy\u2010confirmed CeD was estimated, and the quality of studies appraised.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified and screened the titles and abstracts of 1432 publications, of which 60 were reviewed in full text and 12 were included in the analyses. The overall pooled weighted prevalence of PEI in CeD was 13.5% (95% CI 7.2\u201321.0). The prevalence was similar among children (14.2%; 95% CI 2.0\u201332.8) and adults (12.8%; 95% CI 7.8\u201318.7) with CeD. The prevalence in studies that used secretory testing to define PEI was 13.1% (95% CI 6.4\u201321.3) and in those requiring digestive tests 17.1% (95% CI 5.8\u201332.1). The weighted prevalence of PEI was significantly higher among untreated CeD patients (18.2%) than patients on a gluten\u2010free diet (6.9%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.03), in both adults and children.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>One in eight individuals with CeD may suffer from PEI. The prevalence was particularly high in untreated CeD. PEI should be considered in patients who do not respond to a gluten\u2010free diet.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ueg2.70076","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T13:29:47Z","timestamp":1752067787000},"page":"1107-1115","source":"Crossref","is-referenced-by-count":3,"title":["Pancreatic Exocrine Insufficiency Is Not Uncommon in Celiac Disease: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6496-295X","authenticated-orcid":false,"given":"Miroslav","family":"Vujasinovic","sequence":"first","affiliation":[{"name":"Department of Upper Abdominal Diseases Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Medicine Huddinge Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6657-8268","authenticated-orcid":false,"given":"Nina","family":"Blazevic","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Sisters of Mercy University Hospital Center  Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5309-4704","authenticated-orcid":false,"given":"Patrick","family":"Maisonneuve","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics IEO European Institute of Oncology IRCCS  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1906-4982","authenticated-orcid":false,"given":"Anders","family":"Forss","sequence":"additional","affiliation":[{"name":"Centre for Digestive Health Gastroenterology Unit Department of Gastroenterology Dermatovenereology and Rheumatology Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5930-9884","authenticated-orcid":false,"given":"Nikola","family":"Panic","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit University Hospital Center Dr Dragi\u0161a Mi\u0161ovi\u0107 Dedinje  Belgrade Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3315-528X","authenticated-orcid":false,"given":"Nina","family":"Bloch","sequence":"additional","affiliation":[{"name":"Medical Library Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8283-3185","authenticated-orcid":false,"given":"J. Enrique","family":"Dominguez Munoz","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Hospital of Santiago de Compostela Health Research Institute of Santiago de Compostela (IDIS)  Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1024-5602","authenticated-orcid":false,"given":"Jonas F.","family":"Ludvigsson","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"},{"name":"Celiac Disease Center Department of Medicine Columbia University Medical Center  New York New York USA"},{"name":"Department of Pediatrics \u00d6rebro University Hospital \u00d6rebro University  \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7647-198X","authenticated-orcid":false,"given":"J.\u2010Matthias","family":"L\u00f6hr","sequence":"additional","affiliation":[{"name":"Department of Upper Abdominal Diseases Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Clinical Science Intervention and Technology Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ueg2.12674"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640616684695"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000001732"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640619844125"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002075"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/mpg.0b013e31821a23d0"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/mpg.0000000000002497"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042737\u2010199910000\u201000019"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006676\u2010198603000\u201000006"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.32.7.796"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005176\u2010199810000\u201000008"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1023\/a:1010687918252"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102362.2001.00822.x"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mpg.0000228098.66583.85"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102036.2006.03206.x"},{"issue":"4","key":"e_1_2_11_18_1","first-page":"1191","article-title":"CTLA\u20104 +49 and TNF\u2010Alpha\u2010308 Gene Polymorphisms in Celiac Patients With Exocrine Pancreatic Insufficiency","volume":"37","author":"Licul V.","year":"2013","journal-title":"Collegium Antropologicum"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj\u20102015\u2010133262"},{"issue":"3","key":"e_1_2_11_20_1","first-page":"363","article-title":"Is Pancreatic Exocrine Insufficiency in Celiac Disease Related to Structural Alterations in Pancreatic Parenchyma?","volume":"29","author":"Rana S. 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