Virta L J, Saarinen M M, Kolho K-L
Research Department, The Social Insurance Institution of Finland, Turku, Finland.
Departments of Public Health and Child Neurology, University of Turku and Turku University Hospital, Turku, Finland.
Aliment Pharmacol Ther. 2017 Dec;46(11-12):1085-1093. doi: 10.1111/apt.14335. Epub 2017 Sep 21.
The frequency of coeliac disease (CD) has been on the rise over the past decades, especially in Western Europe, but current trends are unclear.
To research the recent temporal changes in the incidence of adult, biopsy-verified coeliac disease and dermatitis herpetiformis (DH) in Finland, a country with a high frequency of coeliac disease.
All coeliac disease and DH cases diagnosed at age 20-79 years during 2005-2014 were retrieved from a nationwide database documenting all applicants for monthly compensation to cover the extra cost of maintaining a gluten-free diet. This benefit is granted on the basis of histology, not socioeconomic status. Temporal trends in the annual incidences were estimated using Poisson regression analyses.
The total incidence of coeliac disease decreased from 33/100 000 during the years 2005-2006 to 29/100 000 during 2013-2014. The mean annual incidence of coeliac disease was nearly twice as high among women as among men, 42 vs 22 per 100 000, respectively. For middle- and old-aged women, the average rate of decrease in incidence was 4.8% (95% CI 3.9-5.7) per year and for men 3.0% (1.8-4.1) (P for linear trend <.001, for both). Similarly, the annual incidence of DH declined. For young adults, the rate of change remained low and nonsignificant throughout the period 2005-2014.
Although the awareness of coeliac disease has increased during the past decades, the incidence of biopsy-verified diagnoses is not increasing, which suggests that exposure to yet unidentified triggering factors for coeliac disease has plateaued among the Finnish adult population.
在过去几十年中，乳糜泻（CD）的发病率一直在上升，尤其是在西欧，但目前的趋势尚不清楚。
研究在乳糜泻发病率较高的芬兰，经活检确诊的成人乳糜泻和疱疹样皮炎（DH）发病率最近的时间变化。
从一个全国性数据库中检索出2005年至2014年期间诊断为20至79岁的所有乳糜泻和DH病例，该数据库记录了所有申请每月补偿以支付维持无麸质饮食额外费用的人。这种补贴是根据组织学而非社会经济地位给予的。使用泊松回归分析估计年发病率的时间趋势。
乳糜泻的总发病率从2005 - 2006年的33/10万降至2013 - 2014年的29/10万。乳糜泻的年平均发病率女性几乎是男性的两倍，分别为每10万42例和22例。对于中老年女性，发病率的平均下降率为每年4.8%（95%可信区间3.9 - 5.7），男性为3.0%（1.8 - 4.1）（线性趋势P均<0.001）。同样，DH的年发病率也有所下降。对于年轻人，2005年至2014年期间变化率一直较低且无统计学意义。
尽管在过去几十年中对乳糜泻的认识有所提高，但经活检确诊的发病率并未增加，这表明在芬兰成年人群中，接触尚未明确的乳糜泻触发因素已趋于平稳。
