Epidemic of coeliac disease in Swedish children
Epidemic of coeliac disease in Swedish children
复制标题
瑞典儿童中乳糜泻的流行
DOI：
10.1111/j.1651-2227.2000.tb01210.x
复制
发表时间：
2000
期刊：
影响因子：
--
通讯作者：
O. Hernell
中科院分区：
文献类型：
--
作者：
A. Ivarsson;L. Persson;L. Nyström;H. Ascher;B. Cavell;L. Danielsson;A. Dannaeus;T. Lindberg;B. Lindquist;L. Stenhammar;O. Hernell
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 a 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.
