Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.
Am J Gastroenterol. 2020 Apr;115(4):507-525. doi: 10.14309/ajg.0000000000000523.
To conduct a systematic review and meta-analysis that defines the worldwide incidence of celiac disease (CD) and examines temporal trends.
MEDLINE and EMBASE were searched for population-based studies reporting the incidence of CD in the overall population, children, or adults. No limits were placed on year or language of publication. Studies solely examining at-risk populations (e.g., patients with type 1 diabetes) were excluded. Random-effects models were performed to meta-analyze sex- and age-specific incidence in the 21st century. Temporal trend analyses assessed the average annual percent change in CD incidence over time.
Of 11,189 citations, 86 eligible studies were identified for inclusion, of which 50 were deemed suitable for analyses. In the 21st century, the pooled female incidence of CD was 17.4 (95% confidence interval [CI]: 13.7, 21.1) (I = 99.5%) per 100,000 person-years, compared with 7.8 (95% CI: 6.3, 9.2) (I = 98.6%) in males. Child-specific incidence was 21.3 per 100,000 person-years (95% CI: 15.9, 26.7) (I = 99.7%) compared with 12.9 (95% CI: 7.6, 18.2) (I = 99.9%) in adults. Pooling average annual percent changes showed the incidence of CD to be increasing by 7.5% (95% CI: 5.8, 9.3) (I = 79.6%) per year over the past several decades.
Incidence of CD is highest in females and children. Overall, the incidence has been significantly rising in the latter half of the 20th century and into the 21st century throughout the Western world. Population-based studies in Africa, Asia, and Latin America are needed to provide a comprehensive picture of the global incidence of CD.
进行系统评价和荟萃分析，确定全球乳糜泻（CD）的发病率，并探讨时间趋势。
在 MEDLINE 和 EMBASE 中检索了报告总体人群、儿童或成人中 CD 发病率的基于人群的研究。对发表年份和语言没有任何限制。仅检查高危人群（例如 1 型糖尿病患者）的研究被排除在外。使用随机效应模型对 21 世纪性别和年龄特异性发病率进行荟萃分析。时间趋势分析评估了 CD 发病率随时间的平均年变化百分比。
在 11189 条引用中，确定了 86 项符合条件的研究进行纳入，其中 50 项被认为适合分析。在 21 世纪，女性 CD 的合并发病率为每 100000 人年 17.4（95%置信区间[CI]：13.7，21.1）（I = 99.5%），而男性为每 100000 人年 7.8（95%CI：6.3，9.2）（I = 98.6%）。特定于儿童的发病率为每 100000 人年 21.3（95%CI：15.9，26.7）（I = 99.7%），而成年人则为每 100000 人年 12.9（95%CI：7.6，18.2）（I = 99.9%）。汇总平均年度百分比变化显示，过去几十年 CD 的发病率每年以 7.5%（95%CI：5.8，9.3）（I = 79.6%）的速度增长。
CD 的发病率在女性和儿童中最高。总体而言，在 20 世纪后半叶和 21 世纪，整个西方世界的发病率都显著上升。需要在非洲、亚洲和拉丁美洲开展基于人群的研究，以全面了解全球 CD 的发病率。
