Kim W R, Lindor K D, Locke G R, Therneau T M, Homburger H A, Batts K P, Yawn B P, Petz J L, Melton L J, Dickson E R
Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
Gastroenterology. 2000 Dec;119(6):1631-6. doi: 10.1053/gast.2000.20197.
BACKGROUND & AIMS: The epidemiology of primary biliary cirrhosis (PBC) has not been studied systematically in the United States. We report the incidence and prevalence of this condition in the general population. We also examined the validity of the Mayo natural history model for PBC among these unselected patients from the community.
The Rochester Epidemiology Project entails a computerized index of diagnoses from the health care encounters of residents of Olmsted County, Minnesota. For potential cases identified using this database, the complete (inpatient and outpatient) medical records were reviewed to verify the diagnosis and extract information necessary for the application of the Mayo model. We estimated the incidence and prevalence of PBC in this population and compared the actual survival of patients with PBC in the community with the survival predicted for PBC patients by the Mayo natural history model.
The age-adjusted (to 1990 U.S. whites) incidence of PBC per 100,000 person-years for years 1975-1995 was 4.5 (95% confidence interval [CI], 3.1-5.9) for women, 0.7 (95% CI, 0.1-1.3) for men, and 2.7 (95% CI, 1.9-3.5) overall. The age- and sex-adjusted prevalence per 100,000 persons as of 1995 was 65.4 (95% CI, 43.0-87.9) for women, 12.1 (95% CI, 1.1-23.1) for men, and 40.2 (95% CI, 27.2-53.1) overall. The Mayo natural history model accurately predicted the actual survival of these patients.
This first description of the epidemiology of PBC in the United States indicates that its incidence and prevalence in this country are among the highest reported. Outcomes among these unselected patients from a community population further validated the Mayo natural history model of PBC.
原发性胆汁性肝硬化（PBC）的流行病学在美国尚未得到系统研究。我们报告了这种疾病在普通人群中的发病率和患病率。我们还在这些来自社区的未经选择的患者中检验了梅奥PBC自然史模型的有效性。
罗切斯特流行病学项目包含明尼苏达州奥尔姆斯特德县居民医疗保健接触的计算机化诊断索引。对于使用该数据库识别出的潜在病例，查阅完整的（住院和门诊）病历以核实诊断并提取应用梅奥模型所需的信息。我们估计了该人群中PBC的发病率和患病率，并将社区中PBC患者的实际生存率与梅奥自然史模型预测的PBC患者生存率进行了比较。
1975 - 1995年期间，年龄调整后（以1990年美国白人标准）每10万人年的PBC发病率，女性为4.5（95%置信区间[CI]，3.1 - 5.9），男性为0.7（95% CI，0.1 - 1.3），总体为2.7（95% CI，1.9 - 3.5）。截至1995年，年龄和性别调整后的每10万人患病率，女性为65.4（95% CI，43.0 - 87.9），男性为12.1（95% CI，1.1 - 23.1），总体为40.2（95% CI，27.2 - 53.1）。梅奥自然史模型准确预测了这些患者的实际生存率。
美国对PBC流行病学的首次描述表明，该国PBC的发病率和患病率在已报告的情况中处于最高水平。这些来自社区人群的未经选择的患者的结局进一步验证了PBC的梅奥自然史模型。
