Holmes Geoffrey K T, Muirhead A
Royal Derby Hospital, Derby, UK.
Department of Public Health, Derby City Council, Derby, UK.
BMJ Open Gastroenterol. 2017 Apr 1;4(1):e000137. doi: 10.1136/bmjgast-2017-000137. eCollection 2017.
To determine trends in diagnosis of coeliac disease (CD) in patients attending a single centre 1958-2014 and provide figures for prevalence and incidence in those born in Derby city over 4 decades. To explore a link between deprivation and prevalence and characteristics of CD in Asians.
An unselected, consecutive series of 2410 adult patients with CD diagnosed in the catchment area of the Derby hospitals was identified. 1077 born within Derby city identified by postcodes was used to determine changes in prevalence and incidence over 4 decades. 191 patients were Asian. Population numbers were obtained from National Census information.
In the quinquennium 2010-2014, 20 times more patients were diagnosed than during 1975-1979. 27% were diagnosed at ≥60 years. A paucity of diagnoses in young men was observed. Women were diagnosed most often in age band ≥35<45, 15 years earlier than men. The largest increase in diagnosis rates occurred in young women and the elderly. In 2014, overall prevalence was 1:188; women 1:138. 4.6% of the variation was attributed to deprivation. Diagnosis rates in Asians increased markedly although only 5% were diagnosed at ≥60 years, much lower than for whites.
The dramatic increase in number of patients with CD presents challenges for follow-up and new models of care need to be explored. Healthcare workers should be alert to the diagnosis in young men and elderly Asians. A dedicated coeliac clinic is an excellent facility to increase diagnosis rates.
确定1958年至2014年在单一中心就诊的乳糜泻（CD）患者的诊断趋势，并提供40多年来出生在德比市的人群的患病率和发病率数据。探讨贫困与亚洲人CD患病率及特征之间的联系。
在德比医院服务区域内，对2410例确诊为CD的成年患者进行了一项非选择性、连续性研究。通过邮政编码确定出生在德比市内的1077例患者，用于确定40多年来患病率和发病率的变化。其中191例患者为亚洲人。人口数据来自全国人口普查信息。
在2010 - 2014这五年期间，诊断出的患者数量是1975 - 1979年期间的20倍。27%的患者在60岁及以上被诊断出患病。观察到年轻男性的诊断病例较少。女性最常被诊断出患病的年龄区间为≥35岁<45岁，比男性早15年。诊断率增长最大的是年轻女性和老年人。2014年，总体患病率为1:188；女性为1:138。4.6%的差异归因于贫困。亚洲人的诊断率显著上升，尽管只有5%的患者在60岁及以上被诊断出患病，远低于白人。
CD患者数量的急剧增加给随访带来了挑战，需要探索新的护理模式。医护人员应警惕年轻男性和老年亚洲人的诊断。设立专门的乳糜泻诊所是提高诊断率的良好举措。
