Kårhus Line L, Thuesen Betina H, Rumessen Jüri J, Linneberg Allan
aResearch Centre for Prevention and Health, The Capital Region, Glostrup bQ&D, Research Unit and Department of Gastroenterology, Herlev and Gentofte Hospital cDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen dDepartment of Clinical Experimental Research, Rigshospitalet, Denmark.
Eur J Gastroenterol Hepatol. 2016 Nov;28(11):1298-304. doi: 10.1097/MEG.0000000000000709.
To identify possible early predictors (symptoms and biomarkers) of celiac disease, compare symptoms before and after screening, and evaluate the diagnostic efficacy of serologic screening for celiac disease in an adult Danish population.
This cross-sectional population-based study was based on the 5-year follow-up of the Health2006 cohort, where 2297 individuals were screened for celiac disease; 56 were antibody positive and thus invited to clinical evaluation. Eight were diagnosed with biopsy-verified celiac disease. A follow-up questionnaire was sent to antibody-positive individuals 19 months after the clinical evaluation to obtain information on their symptoms and their experience with participation in the screening.
Before screening, participants subsequently diagnosed with celiac disease did not differ from the rest of the population with respect to symptoms, but had significantly lower total cholesterol. Tissue transglutaminase IgA antibodies with a cut-off of 10 U/ml had a positive predictive value of 88%. The majority of participants were satisfied with their participation in the screening program. Individuals with celiac disease were generally satisfied with having been diagnosed and 71% felt better on a gluten-free diet.
There were no differences in the prevalence of symptoms between participants with and without screening-detected celiac disease, confirming that risk stratification in a general population by symptoms is difficult. The majority of participants diagnosed with celiac disease felt better on a gluten-free diet despite not reporting abdominal symptoms before diagnosis and participants in the clinical evaluation were generally satisfied with participation in the screening program.
确定乳糜泻可能的早期预测指标（症状和生物标志物），比较筛查前后的症状，并评估丹麦成年人群中乳糜泻血清学筛查的诊断效力。
这项基于人群的横断面研究基于Health2006队列的5年随访，其中2297人接受了乳糜泻筛查；56人抗体呈阳性，因此被邀请进行临床评估。8人被诊断为经活检证实的乳糜泻。在临床评估19个月后，向抗体阳性个体发送了一份随访问卷，以获取他们的症状信息以及参与筛查的经历。
在筛查前，随后被诊断为乳糜泻的参与者在症状方面与其他人群没有差异，但总胆固醇显著较低。组织转谷氨酰胺酶IgA抗体临界值为10 U/ml时，阳性预测值为88%。大多数参与者对参与筛查项目感到满意。乳糜泻患者总体上对被诊断感到满意，71%的人在无麸质饮食后感觉更好。
筛查发现的乳糜泻患者和未患乳糜泻患者的症状患病率没有差异，这证实了在普通人群中按症状进行风险分层很困难。大多数被诊断为乳糜泻的参与者在无麸质饮食后感觉更好，尽管在诊断前未报告腹部症状，且参与临床评估的参与者总体上对参与筛查项目感到满意。
