Logan R F, Tucker G, Rifkind E A, Heading R C, Ferguson A
Br Med J (Clin Res Ed). 1983 Jan 8;286(6359):95-7. doi: 10.1136/bmj.286.6359.95.
From 1960 to 1979 there was a threefold increase in the number of cases of coeliac disease diagnosed annually in adults in Edinburgh and the Lothians. Women accounted for 80% of the increase and their mean age at diagnosis was significantly reduced. The ratio of female to male new cases changed from 1.25 in the '60s to 2.5 in the '70s. In the period 1975-9 56 of 102 adults with coeliac disease presented with no gastrointestinal symptoms, including 30 cases diagnosed as a result of minor biochemical or haematological abnormalities, such as red-cell macrocytosis without anaemia. Over the same period, only 13 presented with a typical malabsorption syndrome compared to 24 of 38 (63%) in the years 1960-4. During 1975-9 58 new cases had no anaemia, compared with eight (21%) in the earlier period. Hypoproteinaemia (concentration less than 60 g/l) and hypocalcaemia of less than 2.00 mmol/l (8 mg/100 ml) were also less common. Though a real increase in the incidence of coeliac disease cannot be discounted, these changes are more likely to be the result of greater awareness of the disease and a lowered threshold for investigation.
1960年至1979年间，爱丁堡和洛锡安区每年确诊的成人乳糜泻病例数增长了两倍。女性病例数的增长占总增长数的80%，且她们确诊时的平均年龄显著降低。新发病例中女性与男性的比例从60年代的1.25变为70年代的2.5。在1975年至1979年期间，102例成人乳糜泻患者中有56例没有出现胃肠道症状，其中30例是由于轻微的生化或血液学异常而确诊的，比如无贫血的红细胞大细胞症。在同一时期，只有13例患者出现典型的吸收不良综合征，而在1960年至1964年期间，38例中有24例（63%）出现该症状。1975年至1979年期间，58例新发病例无贫血，而早期只有8例（21%）。低蛋白血症（浓度低于60g/L）和血钙浓度低于2.00mmol/L（8mg/100ml）也较少见。虽然不能排除乳糜泻发病率的实际增长，但这些变化更可能是由于对该疾病的认识提高以及检查阈值降低所致。
