Simre Kärt, Uibo Oivi, Peet Aleksandr, Tillmann Vallo, Kool Pille, Hämäläinen Anu-Maaria, Härkönen Taina, Siljander Heli, Virtanen Suvi, Ilonen Jorma, Knip Mikael, Uibo Raivo
Department of Immunology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia; Children's Clinic of Tartu University Hospital, Tartu, Estonia.
Children's Clinic of Tartu University Hospital, Tartu, Estonia; Department of Pediatrics, University of Tartu, Tartu, Estonia.
Dig Liver Dis. 2016 Nov;48(11):1296-1301. doi: 10.1016/j.dld.2016.06.029. Epub 2016 Jul 6.
During the last several decades the prevalence of coeliac disease (CD) has increased worldwide.
To compare the cumulative incidence of CD between Estonian and Finnish children and to identify the risk factors.
Children were recruited as part of the DIABIMMUNE Study. In the birth cohort (BC) 258 children from Estonia and 305 from Finland, and in the young children's cohort (YCC) 1363 and 1384 children were followed up, respectively. The diagnosis of CD was made in accordance with the ESPGHAN guidelines-the presence of IgA-tTG antibodies and small bowel villous atrophy.
During the study period 29 children developed CD. The cumulative incidence of CD was significantly higher in Finland (0.77% vs 0.27%; P=0.01). No difference was seen between the children with CD and the controls in the duration of breastfeeding or the age at cereal introduction. The BC children with CD had had significantly more episodes of infections with fever by the age of 12 months compared to the controls (3.4 vs 1.4; P=0.04).
The 5-year cumulative incidence of childhood CD is significantly higher in Finland than in Estonia. Sequential infections early in life may increase the risk for developing CD.
在过去几十年间，全球乳糜泻（CD）的患病率有所上升。
比较爱沙尼亚和芬兰儿童CD的累积发病率，并确定风险因素。
儿童作为DIABIMMUNE研究的一部分被招募。在出生队列（BC）中，分别对来自爱沙尼亚的258名儿童和来自芬兰的305名儿童进行随访，在幼儿队列（YCC）中，分别对1363名和1384名儿童进行随访。CD的诊断依据ESPGHAN指南——存在IgA - tTG抗体和小肠绒毛萎缩。
在研究期间，有29名儿童患上CD。芬兰CD的累积发病率显著更高（0.77%对0.27%；P = 0.01）。CD患儿与对照组在母乳喂养时长或开始食用谷物的年龄方面未发现差异。与对照组相比，BC队列中患CD的儿童在12个月大时发烧感染的次数显著更多（3.4次对1.4次；P = 0.04）。
芬兰儿童CD的5年累积发病率显著高于爱沙尼亚。生命早期的连续性感染可能会增加患CD的风险。
