Epidemiology of Celiac Disease: A Population Based Study

乳糜泻（CD）是消化系统最常见的慢性疾病之一， 可通过排除饮食麸质来治疗。在初步研究中，我们发现，沉默乳糜泻的患病率 这种疾病接近美国人口的1%，并且在其家庭成员患有CD或I型的那些人中占4- 10 糖尿病（T1 DM）。症状性CD可能是一种毁灭性的疾病， 死亡率和大量的发病率，其中大部分是可以预防或可逆的无麸质饮食 （GFD）。血清学检测可以很容易地检测出大量的个人与CD的情况下， 典型症状然而，目前尚不清楚是否所有CD患者都会发生不良结局，还是仅小部分CD患者会发生不良结局。 临床上很明显的部分至关重要的是要了解沉默和 因此得不到治疗的腹腔疾病我们将检测奥姆斯特德居民的血清 县，一个医学研究良好的人口，以确定那些与沉默乳糜泻。我们建立 临床诊断CD的患病率及其亲属和T1 DM患者的患病率， 贫血在这个社区。这解决了未诊断的乳糜泻在美国很常见的假设 今天的普通民众。为了验证腹腔疾病在50年前和现在一样普遍的假设 今天，CD在50岁的血清中的患病率从一个大型的历史军事队列的年轻人 将对45年结局数据可用的患者进行类似分析。两军交战的结果 死亡率方面的队列已经建立，从而使我们能够测试的假设， 乳糜泻最终与超过45年的存活率降低相关。一旦那些有无声CD的人 在奥姆斯特德县确定，我们可以确定乳糜泻的长期发病率，首先检查 在采样日期之前和之后记录的有和无CD证据的受试者的所有诊断。 其次，我们将通过病例对照研究来检验疾病关联。第三，我们将确定 军事队列使用的数据已经抽象到1996年。这个项目对公众的意义 它将提供关于沉默乳糜泻的长期结果的新的全面信息， 疾病在很长一段时间。这将提供关键数据，以确定是否需要尽早 通过筛查和治疗无症状乳糜泻来检测，这可能会影响1%的美国人。

Celiac disease (CD) is one of the most common chronic diseases of the digestive system, and is readily treatable with exclusion of dietary gluten. In preliminary studies we found that the prevalence of silent celiac disease is close to 1 % of the US population and 4-10% of those whose family members have CD or type one diabetes mellitus (T1DM). Symptomatic CD can be a devastating illness that is associated with a doubling of mortality and substantial morbidity, and much of this is preventable or reversible with the gluten free diet (GFD). Serological testing can readily detect substantial numbers of individuals with CD in the absence of classical symptoms. However it is not clear if adverse outcomes occur in all patients with CD or just the small part that are clinically obvious. It is of crucial importance to know the long-term outcome of silent and hence untreated, celiac disease. We will test the stored serum of large cohorts of residents from Olmsted County, a medically well studied population to identify those with silent celiac disease. We have established the prevalence of clinically diagnosed CD and the prevalence in their relatives and those with T1DM and anemia in this community. This addresses the hypothesis that undiagnosed celiac disease is common in the generalpopulation today. To test the hypothesis that celiac disease was as prevalent 50 years ago as it is today, the prevalence of CD in 50-year-old serum taken from a large historical military cohort of young adults for whom 45-year outcome data are available will be similarly analyzed. The outcome of both of the military cohort in terms of mortality has been established thereby allowing us to test the hypothesis that undetected celiac disease is ultimately associated with decreased survival over 45 years. Once those with silent CD are identified in Olmsted County we can determine the long-term morbidity of celiac disease, by first examining all diagnoses recorded before and after the sample date for subjects with and without evidence of CD. Secondly we will test disease association by case-control studies. Thirdly, we will determine morbidity of the military cohort using data already abstracted through 1996. The significance of this project for the public health is that it will provide novel comprehensive information on the long-term outcome of silent celiac disease over a long period of time. This will provide crucial data that will determine the need for early detection by screening and treatment of silent celiac disease, which may affect 1% of Americans.