Center for Celiac Research and Mucosal Biology Research Center, University of Maryland School of Medicine, Baltimore, MD, USA.
Ann Med. 2010 Oct;42(7):530-8. doi: 10.3109/07853890.2010.514285.
The natural history and the possible changes of celiac disease (CD) prevalence over time are still unclear.
We analyzed 3,511 subjects with matched samples from 1974 (CLUE I) and 1989 (CLUE II). To avoid a selection bias regarding survival, we also screened 840 CLUE I participants who deceased after the 1974 survey. Outcome measure. CD autoimmunity (positivity to auto-antibodies) over time.
CD autoimmunity was detected in seven subjects in 1974 (prevalence 1:501) and in an additional nine subjects in 1989 (prevalence 1:219). Two cases of CD autoimmunity were found among the 840 subjects deceased after CLUE I. Compared to controls, untreated CD subjects showed increased incidence of osteoporosis and associated autoimmune disorders, but they did not reach statistical significance.
During a 15-year period CD prevalence increased 2-fold in the CLUE cohort and 5-fold overall in the US since 1974. The CLUE study demonstrated that this increase was due to an increasing number of subjects that lost the immunological tolerance to gluten in their adulthood.
乳糜泻（CD）的自然史和患病率随时间变化的可能变化仍不清楚。
1）确定对麸质的耐受性丧失是否可能发生在任何年龄；2）研究 CD 患病率随时间的可能变化；3）研究 CD 相关的合并症。
我们分析了 1974 年（CLUE I）和 1989 年（CLUE II）的 3511 名匹配样本的受试者。为了避免与生存有关的选择偏倚，我们还筛选了 1974 年调查后死亡的 840 名 CLUE I 参与者。结果测量。随时间推移的 CD 自身免疫（自身抗体阳性）。
1974 年发现 7 例 CD 自身免疫（患病率 1:501），1989 年发现另外 9 例（患病率 1:219）。在 CLUE I 后死亡的 840 名受试者中发现了 2 例 CD 自身免疫。与对照组相比，未经治疗的 CD 患者骨质疏松症和相关自身免疫性疾病的发病率增加，但未达到统计学意义。
在 15 年期间，CLUE 队列中的 CD 患病率增加了 2 倍，而自 1974 年以来美国的总体患病率增加了 5 倍。CLUE 研究表明，这种增加是由于成年后失去对麸质免疫耐受性的受试者数量增加所致。
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