Screening for Celiac Disease in a North American Population: Sequential Serology and Gastrointestinal Symptoms
Screening for Celiac Disease in a North American Population: Sequential Serology and Gastrointestinal Symptoms
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DOI：
10.1038/ajg.2011.21
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发表时间：
2011-07-01
影响因子：
9.8
通讯作者：
Murray, Joseph A.
中科院分区：
文献类型：
--
作者：
Katz, Kent D.;Rashtak, Shahrooz;Murray, Joseph A.
目的：在美国，乳糜泻的患病率<1/2000，但在欧洲和其他人群中进行的筛查研究显示患病率要高得多。本研究的目的是确定乳糜泻的患病率和实用程序的筛选在一般成人人口的地理隔离area.METHODS：血清组织转氨酶抗体（tTG-IgA）进行了测量，在志愿者的健康护理参与者年龄>= 18岁，在每年的卡斯珀，怀俄明州，蓝信封健康博览会抽血。tTG-IgA试验阳性的受试者进行肌内膜IgA抗体检查。提供双阳性内镜检查和小肠活检。所有受试者完成了一个简短的胃肠道（GI）症状questionnaire. RESULTS：共有3,850居民的纳特罗纳县有乳糜泻的血清学评价，其中34人测试阳性的tTG和肌内膜抗体（EMA）IgA。排除三个人与先前的诊断腹腔疾病，阳性腹腔血清学在这个社区样本的总体患病率为0.8%。所有31例受试者均接受了小肠活检。在18例活检受试者中，17例（94%）至少有部分绒毛萎缩。由公平的与会者报告的症状并没有预测positive.CONCLUSIONS：腹腔疾病的筛查被广泛接受，在这种预防性的卫生保健设置。在这个怀俄明州社区，未确诊的乳糜泻影响着126个人中的1个。大多数无症状或有非典型表现。血清学检测可以很容易地在一般人群中发现这种疾病。
OBJECTIVES: The prevalence of diagnosed celiac disease is < 1 in 2,000 in the United States, but screening studies undertaken in European and other populations have revealed a much higher prevalence. The objective of this study was to determine the prevalence of celiac disease and the utility of screening in the general adult population of a geographically isolated area.METHODS: Serum tissue transglutaminase antibodies (tTG-IgA) were measured in volunteer health-care participants aged >= 18 years at the annual Casper, Wyoming, Blue Envelope Health Fair blood draw. Subjects with positive tTG-IgA tests had their endomysial IgA antibodies checked. Double positives were offered endoscopy with small bowel biopsy. All subjects completed a short gastrointestinal (GI) symptom questionnaire.RESULTS: A total of 3,850 residents of the Natrona County had serologic evaluation for celiac disease, 34 of whom tested positive for both tTG and endomysial antibody (EMA) IgA. Excluding three individuals with previous diagnosis of celiac disease, the overall prevalence of positive celiac serology in this community sample was 0.8%. All 31 subjects were offered a small bowel biopsy. Of the 18 biopsied subjects, 17 (94%) had at least partial villous atrophy. Symptoms that were reported by the fair attendees did not predict positivity.CONCLUSIONS: Screening for celiac disease was widely accepted in this preventative health-care setting. Undiagnosed celiac disease affects 1 in 126 individuals in this Wyoming community. Most were asymptomatic or had atypical presentations. Serologic testing can readily detect this disease in a general population.