Epidemic of coeliac disease in Swedish children
Epidemic of coeliac disease in Swedish children
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DOI：
10.1080/080352500750028771
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发表时间：
2000-02-01
期刊：
影响因子：
3.8
通讯作者：
Hernell, O
中科院分区：
文献类型：
--
作者：
Ivarsson, A;Persson, LÅ;Hernell, O
乳糜泻已成为一个公共卫生问题。本研究的目的是分析1973年至1997年瑞典儿童有症状乳糜泻发生的趋势，并探讨婴儿饮食模式变化的时间关系。我们于1991年建立了一个以人群为基础的腹腔疾病前瞻性发病率登记册，此外，还收集了1973年的回顾性数据。共有2151例符合诊断标准。此外，我们还收集了全国性的数据，包括每年母乳喂养的持续时间、含麸质谷物的摄入量以及何时以及如何将麸质引入婴儿饮食的建议。从1985年到1987年，2岁以下儿童的年发病率增加了四倍，达到每10万人年200-240例，从1995年起急剧下降到以前的每10万人年50-60例。这种流行模式是非常独特的慢性疾病的免疫发病机制，这表明预防是可能的。在这项研究中所作的生态观察是兼容的流行病的结果，至少部分地，在婴儿喂养的领域内，即谷蛋白的量，在引进谷蛋白的年龄，以及是否母乳喂养正在进行或没有谷蛋白时，改变和三个因素之间的相互作用。其他因素也可能起了作用，应加强对这些因素的研究。
Coeliac disease has emerged as a public health problem. The aim of the present study was to analyse trends in the occurrence of symptomatic coeliac disease in Swedish children from 1973 to 1997, and to explore any temporal relationship to changes in infant dietary patterns. We established a population-based prospective incidence register of coeliac disease in 1991, and, in addition, retrospective data from 1973 were collected. A total of 2151 cases fulfilled the diagnostic criteria. Furthermore, we collected national data on;I yearly basis on duration of breastfeeding, intake of gluten-containing cereals and recommendations on when and how to introduce gluten into the diet of infants. From 1985 to 1987 the annual incidence rate in children below 2 y of age increased fourfold to 200-240 cases per 100 000 person years, followed from 1995 by a sharp decline to the previous level of 50-60 cases per 100 000 person years. This epidemic pattern is quite unique for a chronic disease of immunological pathogenesis, suggesting that prevention could be possible. The ecological observations made in this study are compatible with the epidemic being the result, at least in part, of a change in and an interplay among three factors within the area of infant feeding, i.e. amount of gluten given, age at introduction of gluten, and whether breastfeeding was ongoing or not when gluten was introduced. Other factor(s) may also have contributed, and the search for these should be intensified.