Riestra S, Fernández E, Rodrigo L, Garcia S, Ocio G
Gastroenterology Section and Biochemical Service, Hospital Valle del Nalón, Riaño-Langreo, Asturias, Spain.
Scand J Gastroenterol. 2000 Apr;35(4):398-402. doi: 10.1080/003655200750023967.
Coeliac disease (CD) is common in Western countries. In Spain, however, no studies exist on its prevalence. The best method for serologic screening is also unknown.
We determined the IgA and IgG antigliadin antibodies (AGA) and IgA antiendomysium antibodies (AEA) in a sample of 1170 randomly selected subjects from a health area in northern Spain. The prevalence of CD was calculated with a two-step serologic screening method (first IgA and IgG AGA and then AEA in those positive for AGA) or with only one step with AEA determination. Diagnosis was confirmed by small-intestinal biopsy.
When using a two-step strategy, we found 174 (15%) subjects with AGA. Only one of these was confirmed by means of AEA (prevalence of CD = 0.9/1000). Two subjects were found to be positive when a one-step strategy was used (prevalence of CD = 1.7/1000). This yielded an economic saving of 19% with regard to the use of a two-step strategy. One new case of CD in a seronegative subject was diagnosed during the study (real prevalence of CD = 2.6/1000; 95% confidence interval = 0.7-8.2).
The prevalence of CD in Northern Spain is 2.6/1000 (1:389). One-step serologic screening (AEA) is both more economical and more sensitive than the two-step procedure (first AGA and then AEA if AGA is positive).
乳糜泻（CD）在西方国家很常见。然而，在西班牙，尚无关于其患病率的研究。血清学筛查的最佳方法也尚不清楚。
我们在西班牙北部一个健康区域随机选取的1170名受试者样本中检测了IgA和IgG抗麦胶蛋白抗体（AGA）以及IgA抗肌内膜抗体（AEA）。采用两步血清学筛查方法（首先检测IgA和IgG AGA，然后对AGA阳性者检测AEA）或仅一步检测AEA来计算CD的患病率。通过小肠活检确诊。
采用两步策略时，我们发现174名（15%）受试者AGA阳性。其中只有1人通过AEA确诊（CD患病率 = 0.9/1000）。采用一步策略时发现2名受试者阳性（CD患病率 = 1.7/1000）。与两步策略相比，这在费用上节省了19%。在研究期间，一名血清学阴性受试者被诊断为新的CD病例（CD实际患病率 = 2.6/1000；95%置信区间 = 0.7 - 8.2）。
西班牙北部CD的患病率为2.6/1000（1:389）。一步血清学筛查（AEA）比两步程序（首先检测AGA，若AGA阳性则检测AEA）更经济且更敏感。
