West J, Logan R F A, Hill P G, Lloyd A, Lewis S, Hubbard R, Reader R, Holmes G K T, Khaw K-T
University of Nottingham, Division of Epidemiology and Public Health, Medical School, Queen's Medical Centre, Nottingham NG7 2UH, UK.
Gut. 2003 Jul;52(7):960-5. doi: 10.1136/gut.52.7.960.
To examine the seroprevalence, correlates, and characteristics of undetected coeliac disease in a large adult population sample in Cambridge, UK.
The Cambridge General Practice Health Study invited individuals from 12 general practices, aged 45-76 years, to attend for a health survey that included a bone density measurement, between 1990 and 1995. A total of 7550 participants' serum samples were tested for antiendomysial antibody (EMA). Seroprevalence of undetected coeliac disease was based on EMA positivity. Differences between EMA positive and negative participants of various physiological correlates and reported characteristics were estimated by multivariate logistic and linear regression and adjusted for age, sex, social class, and smoking behaviour.
The seroprevalence of undetected coeliac disease in this general population sample aged 45-76 was 1.2% (95% confidence interval (CI) 0.9-1.4). EMA positive participants (n=87) were on average slightly lighter by 2.2 kg (p=0.08), were more likely to have reported their general health as being "good or excellent" (odds ratio (OR) 1.76 (95% CI 0.90-3.46)), and were less likely to report being a current smoker (OR for current versus never 0.36 (95% CI 0.14-0.90)) than EMA negative participants. EMA positivity was associated with an 8% reduction in mean serum cholesterol (0.5 mmol/l; p<0.01) and reductions in mean haemoglobin (0.3 g/dl; p<0.01), total protein (1.0 g/l; p<0.05), and corrected serum calcium (0.02 mmol/l; p<0.05). There was an increased risk of osteoporosis in EMA positive participants (OR 3.1 (95% CI 1.3-7.2)) and of mild anaemia (OR 4.6 (95% CI 2.5-8.2)) compared with EMA negative participants.
Undetected coeliac disease is likely to affect approximately 1% of the population of England aged 45-76 years, a value similar to several other countries. Those affected report "better health" but they do have an increased risk of osteoporosis and mild anaemia. In contrast, they have a favourable cardiovascular risk profile that may afford protection from ischaemic heart disease and stroke.
在英国剑桥的一个大型成年人群样本中，研究未被检测出的乳糜泻的血清流行率、相关因素及特征。
剑桥全科医疗健康研究邀请了来自12家全科诊所、年龄在45 - 76岁之间的个体参加一项健康调查，该调查包括1990年至1995年间的骨密度测量。共对7550名参与者的血清样本进行了抗肌内膜抗体（EMA）检测。未被检测出的乳糜泻的血清流行率基于EMA阳性结果。通过多变量逻辑回归和线性回归估计EMA阳性和阴性参与者在各种生理相关因素和报告特征方面的差异，并对年龄、性别、社会阶层和吸烟行为进行了调整。
在这个45 - 76岁的普通人群样本中，未被检测出的乳糜泻的血清流行率为1.2%（95%置信区间（CI）0.9 - 1.4）。EMA阳性参与者（n = 87）平均体重略轻2.2千克（p = 0.08），更有可能报告自己的总体健康状况为“良好或优秀”（优势比（OR）1.76（95% CI 0.90 - 3.
