Bottaro G, Cataldo F, Rotolo N, Spina M, Corazza G R
I Pediatric Clinic, Catania University, Italy.
Am J Gastroenterol. 1999 Mar;94(3):691-6. doi: 10.1111/j.1572-0241.1999.00938.x.
The demographic, clinical, and epidemiological features of subclinical/silent celiac disease in Italy were analyzed in a multicenter study carried out with the participation of 42 centers, in the years between 1990 and 1994.
One thousand twenty-six subclinical/silent patients (644 children and 382 adults, 702 women and 324 men) were considered eligible for the study.
The prevalence of the subclinical/silent form increased significantly during the study both in adults (p < 0.001) and in children (p < 0.005), but its prevalence was always lower (p < 0.001) in children than in adults. This increase appears more likely due to a greater diagnostic awareness and to a better use of screening than to a higher number of subclinical/silent cases. Whereas in 1990 a significantly higher proportion (p < 0.001) of subclinical/silent celiac patients was diagnosed in Northern Italy rather than in Southern-Insular Italy, both in adults (46.7% vs 17.2%) and in children (22.0% vs 9.0%), in 1994 such a difference was no longer conspicuous. Both in children and in adults, iron-deficiency anemia appeared to be the most frequent extraintestinal symptom, followed by short stature in children and cutaneous lesions of dermatitis herpetiformis in adults. In 25.9% of the cases another disease was present, with a significantly higher frequency (p < 0.05) in adults (30.1%) than in children (20.7%). Diabetes and atopy appeared to be the most frequently associated conditions both in children and in adults.
This study has provided an analysis of the largest series of subclinical/silent celiac disease reported to date. In Italy, this form is most frequently recognized in adults, and prospective studies will clarify whether the lower frequency observed in children is a real or apparent phenomenon.
在1990年至1994年间，由42个中心参与开展了一项多中心研究，对意大利亚临床/隐匿性乳糜泻的人口统计学、临床和流行病学特征进行分析。
1026例亚临床/隐匿性患者（644名儿童和382名成人，702名女性和324名男性）被认为符合该研究的条件。
在研究期间，亚临床/隐匿性形式的患病率在成人（p < 0.001）和儿童（p < 0.005）中均显著增加，但儿童中的患病率始终低于成人（p < 0.001）。这种增加似乎更可能是由于诊断意识的提高和筛查的更好应用，而非亚临床/隐匿性病例数量的增加。1990年，在意大利北部被诊断出的亚临床/隐匿性乳糜泻患者比例显著高于意大利南部-岛屿地区（p < 0.001），在成人中（46.7%对17.2%）和儿童中（22.0%对9.0%）均如此，而在1994年这种差异不再明显。在儿童和成人中，缺铁性贫血似乎是最常见的肠外症状，儿童中其次是身材矮小，成人中是疱疹样皮炎的皮肤病变。在25.9%的病例中还存在另一种疾病，成人中的频率（30.1%）显著高于儿童（20.7%）（p < 0.05）。糖尿病和特应性似乎是儿童和成人中最常伴随的病症。
本研究对迄今为止报道的最大系列亚临床/隐匿性乳糜泻进行了分析。在意大利，这种形式在成人中最常被识别，前瞻性研究将阐明儿童中观察到的较低频率是真实现象还是表观现象。
