Schneider Children's Medical Center, Institute for Gastroenterology, Nutrition and Liver Diseases, Petach Tikva, Israel.
Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel.
United European Gastroenterol J. 2019 Apr;7(3):412-418. doi: 10.1177/2050640618818227. Epub 2018 Dec 6.
Recent studies suggest that the prevalence of celiac disease is rising. We previously established the prevalence of celiac disease in healthy blood donors in 2002.
The purpose of this study was to examine whether the prevalence of celiac disease and celiac disease autoimmunity has changed over time by performing a similar prospective study.
Healthy blood donors ( = 1908) were tested for tissue transglutaminase antibodies and for anti-endomysial antibodies when positive. Further evaluation followed accepted criteria for diagnosis.
Overall, 32 donors had abnormal tissue transglutaminase antibodies (1.68%). Eight donors had tissue transglutaminase antibodies >3 × upper limit of normal (0.42%), two of them with tissue transglutaminase antibodies >10 × upper limit of normal, while 24 donors had tissue transglutaminase antibodies <3 × upper limit of normal (1.26%). Most of the donors with positive tissue transglutaminase antibodies <3 × upper limit of normal had negative tissue transglutaminase antibodies levels on repeated testing (18/19). Celiac disease was diagnosed in four donors with positive tissue transglutaminase antibodies, establishing a prevalence of 1.68% (95% confidence interval 1.15-2.3) for celiac disease autoimmunity and 0.21% for celiac disease (95% confidence interval 0.07-0.5%).
The prevalence of celiac disease in blood donors in Israel did not rise in the last 15 years, suggesting that the increased prevalence of diagnosed celiac disease is mainly due to increased awareness. As most of the donors with elevated tissue transglutaminase antibodies <3 × upper limit of normal were endomysial antibody negative and had a negative tissue transglutaminase antibodies result upon re-testing, repeated tissue transglutaminase antibodies testing is required when screening asymptomatic populations for celiac disease.
最近的研究表明，乳糜泻的患病率正在上升。我们之前在 2002 年确定了健康献血者中乳糜泻的患病率。
本研究旨在通过进行类似的前瞻性研究，检查乳糜泻和乳糜泻自身免疫的患病率是否随时间发生了变化。
对 1908 名健康献血者进行组织转谷氨酰胺酶抗体和抗内肌膜抗体检测，阳性者进一步进行检测。进一步的评估遵循公认的诊断标准。
共有 32 名献血者的组织转谷氨酰胺酶抗体异常（1.68%）。8 名献血者的组织转谷氨酰胺酶抗体>3×正常值上限（0.42%），其中 2 名>10×正常值上限，而 24 名献血者的组织转谷氨酰胺酶抗体<3×正常值上限（1.26%）。大多数组织转谷氨酰胺酶抗体<3×正常值上限的阳性献血者，其组织转谷氨酰胺酶抗体水平在重复检测时为阴性（19 例中有 18 例）。4 名组织转谷氨酰胺酶抗体阳性的献血者被诊断为乳糜泻，确立了乳糜泻自身免疫的患病率为 1.68%（95%置信区间为 1.15-2.3），乳糜泻的患病率为 0.21%（95%置信区间为 0.07-0.5%）。
在过去的 15 年中，以色列献血者中乳糜泻的患病率没有上升，这表明诊断出的乳糜泻患病率的增加主要归因于意识的提高。由于大多数组织转谷氨酰胺酶抗体<3×正常值上限的献血者抗内肌膜抗体阴性，且重复检测时组织转谷氨酰胺酶抗体结果为阴性，因此在对无症状人群进行乳糜泻筛查时，需要重复进行组织转谷氨酰胺酶抗体检测。
