Cook H B, Burt M J, Collett J A, Whitehead M R, Frampton C M, Chapman B A
Department of Gastroenterology, Christchurch Hospital and Christchurch School of Medicine, New Zealand.
J Gastroenterol Hepatol. 2000 Sep;15(9):1032-6. doi: 10.1046/j.1440-1746.2000.02290.x.
Although coeliac disease is a common condition, the role of population screening is not clear. The aim of this study was to determine the prevalence and clinical significance of coeliac disease in the adult population of Christchurch, New Zealand.
A total of 1064 adults randomly selected from the 1996 Christchurch electoral rolls were enlisted. The subjects were screened for coeliac disease using the anti-endomysial antibody test (EMA), and all those with positive tests were reviewed and underwent a small bowel biopsy.
Twelve of the 1064 persons tested (1.1%) were EMA positive and all had small bowel biopsy histology consistent with coeliac disease. Two of the 12 subjects were previously known to be EMA positive although neither had a small bowel biopsy. One additional subject with known and treated coeliac disease was also enrolled but was EMA negative. Thus, the overall prevalence of coeliac disease was 13 of 1064 subjects (1.2%, or 1:82), 10 of whom were newly diagnosed (0.9%, or 1:106) and three were previously known or suspected to have coeliac disease (0.3%, or 1:355). The prevalence in both sexes was similar. Nine of the 12 EMA-positive coeliac disease subjects identified by the use of screening reported symptoms, of which tiredness and lethargy were the most common. The subjects were of normal stature, although females tended to be lean. None of the subjects were anaemic, but four were iron deficient and four folate deficient. Five of the 12 had sustained bone fractures. Bone mineral density was reduced in males but not in females.
The prevalence of coeliac disease in the adult population of Christchurch, New Zealand, is 1.2%. Unrecognized coeliac disease which was detected by population screening was three-fold more common than proven or suspected coeliac disease. Population screening may identify subjects who could benefit from treatment.
尽管乳糜泻是一种常见病症，但人群筛查的作用尚不清楚。本研究的目的是确定新西兰克赖斯特彻奇成年人群中乳糜泻的患病率及其临床意义。
从1996年克赖斯特彻奇选民名册中随机选取1064名成年人。采用抗肌内膜抗体检测（EMA）对受试者进行乳糜泻筛查，所有检测呈阳性者均接受复查并进行小肠活检。
1064名检测者中有12人（1.1%）EMA检测呈阳性，且所有患者的小肠活检组织学结果均符合乳糜泻。12名受试者中有2人之前已知EMA检测呈阳性，但均未进行小肠活检。另外还纳入了1名已知患有并已接受治疗的乳糜泻患者，但该患者EMA检测呈阴性。因此，乳糜泻的总体患病率为1064名受试者中的13人（1.2%，即1:82），其中10人是新诊断出的（0.9%，即1:106），3人之前已知或疑似患有乳糜泻（0.3%，即1:355）。男女患病率相似。通过筛查确定的12名EMA阳性乳糜泻受试者中有9人报告有症状，其中疲劳和嗜睡最为常见。受试者身材正常，不过女性往往偏瘦。所有受试者均无贫血，但有4人缺铁，4人缺叶酸。12人中有5人曾发生过骨折。男性骨密度降低，女性则未降低。
新西兰克赖斯特彻奇成年人群中乳糜泻的患病率为1.2%。通过人群筛查发现的未被识别的乳糜泻比已确诊或疑似的乳糜泻常见三倍。人群筛查可能会识别出可从治疗中获益的受试者。
