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，极易发病。 可以在排除膳食面筋的情况下治疗。在初步研究中，我们发现沉默的乳糜泻的流行 疾病接近美国人口的1%，家庭成员患有CD或1型疾病的人中有4%-10% 糖尿病(T1 DM)。有症状的CD可能是一种毁灭性的疾病，与加倍的 死亡率和相当大的发病率，其中大部分是可以通过无麸质饮食预防或逆转的 (GFD)。血清学检测可以在缺乏CD的情况下很容易地检测出相当数量的CD患者 典型症状。然而，目前还不清楚是所有CD患者都会出现不良后果，还是只有小的CD患者会出现不良后果 临床上很明显的部分。了解沉默和沉默的长期结果至关重要 因此，未经治疗的乳糜泻。我们将检测奥姆斯特德大量居民的储存血清 县，一个经过医学研究的人群，以识别那些患有沉默的乳糜泻的人。我们已经确立了 临床诊断为CD的患病率及其亲属和T1 DM患者的患病率 这个社区的贫血症。这解决了这样一种假设，即未诊断的乳糜泻在 今天的普通民众。来检验50年前乳糜泻和现在一样流行的假说 今天，Cd在50岁的血清中的流行率来自于一大批历史上的年轻人 对于那些有45年成果数据的人，将进行类似的分析。双方军事行动的结果 死亡率方面的队列已经建立，从而使我们能够检验未被检测到的假设 乳糜泻最终与超过45年的存活率下降有关。一旦那些拥有沉默CD的人 在奥姆斯特德县，我们可以通过第一次检查来确定乳糜泻的长期发病率 有无CD证据的受试者在样本日期之前和之后记录的所有诊断。 其次，我们将通过病例对照研究来检验疾病的相关性。第三，我们将确定该病的发病率 使用1996年前已经提取的数据的军事队列。这个项目对公众的意义 健康是，它将提供有关静止性乳酸菌长期结局的新的全面信息 疾病持续很长一段时间。这将提供关键数据，以确定是否需要及早 通过筛查和治疗沉默的乳糜泻进行检测，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.