Corrao G, Usai P, Galatola G, Ansaldi N, Meini A, Pelli M A, Castellucci G, Corazza G R
Institute of Statistical and Mathematical Sciences, University of Milan, Italy.
J Epidemiol Community Health. 1996 Jun;50(3):299-305. doi: 10.1136/jech.50.3.299.
To estimate the incidence rate of newly diagnosed cases of coeliac disease in Italy.
This was a descriptive study of coeliac disease incidence in the period 1990-91.
During 1990-91 newly diagnosed cases of coeliac disease were signalled by several sources including diagnostic records of departments of paediatrics, general medicine and gastroenterology, national health service records for the supply of gluten free diets and the archives of the Italian Coeliac Society.
Altogether 1475 cases were flagged throughout Italy, 478 of whom were selected, corresponding to 270 individual patients from a target population resident in four areas: Provices of Turin and Cuneo (Piedmont Region, northern Italy); Province of Brescia (Lombardia Region, northern Italy); Umbria Region (central Italy) and Sardinia Region (insular Italy). Only for these areas were patients flagged from several sources and the reference population was identifiable.
The overall crude incidence rates for all ages per 100,000 residents per year were 2.4, 2.7, 1.5, and 1.7 in the four areas, respectively. The childhood cumulative incidence rates (aged < or = 15 years) per 100,000 live births were 143, 141, 72, and 80 respectively. The mean ages at diagnosis were similar for both childhood and adult cases throughout the areas--these were around 4 and 34 years respectively. For each area, the incidence rate was constantly higher in the main city than elsewhere. Using the capture-recapture method, an estimated completeness of case archives of 0.84 was obtained, whereas this figure was only 0.47 for hospital sources.
This population based study on the incidence of coeliac disease shows that several information sources should be used to avoid underestimation. The incidence rate of coeliac disease in Italy was among the highest in Europe, and was widely variable showing highest figures in Piedmont and Lombardia and the lowest in Umbria and Sardinia. This trend was not due to different age at diagnosis, which suggests variable diagnostic awareness of the disease rather than different environmental patterns affecting the clinical presentation.
评估意大利新诊断乳糜泻病例的发病率。
这是一项关于1990 - 1991年期间乳糜泻发病率的描述性研究。
在1990 - 1991年期间，多个来源报告了新诊断的乳糜泻病例，包括儿科、普通内科和胃肠病科的诊断记录、国家卫生服务机构提供无麸质饮食的记录以及意大利乳糜泻协会的档案。
意大利各地共标记出1475例病例，从中选取了478例，对应来自四个地区常住目标人群中的270名个体患者：都灵省和库内奥省（意大利北部皮埃蒙特地区）；布雷西亚省（意大利北部伦巴第地区）；翁布里亚地区（意大利中部）和撒丁岛地区（意大利岛屿地区）。仅在这些地区，病例是由多个来源标记的，且参考人群是可识别的。
四个地区每年每10万居民中所有年龄段的总体粗发病率分别为2.4、2.7、1.5和1.7。每10万活产儿中儿童期（年龄≤15岁）的累积发病率分别为143、141、72和80。各地区儿童和成人病例的诊断平均年龄相似，儿童约为4岁，成人约为34岁。在每个地区，主要城市的发病率始终高于其他地方。采用捕获 - 再捕获法，病例档案的估计完整性为0.84，而医院来源的这一数字仅为0.47。
这项基于人群的乳糜泻发病率研究表明，应使用多个信息来源以避免低估。意大利乳糜泻的发病率在欧洲处于最高水平之一，且差异很大，皮埃蒙特和伦巴第地区发病率最高，翁布里亚和撒丁岛地区最低。这种趋势并非由于诊断年龄不同，这表明对该疾病的诊断意识存在差异，而非影响临床表现的环境模式不同。
