Epidemiology of Celiac Disease: A Population Based Study

乳糜泻的流行病学：基于人群的研究

• 批准号: 7786216
• 负责人: Joseph A Murray
• 金额: $ 36.01万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-07-15 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7786216
• 关键词: Address; Adult; Affect; Age; Age-Years; American; Anemia; Biological Assay; CD28 gene; Case-Control Studies; Celiac Disease; Chronic; Chronic Disease; Cohort Studies; Collection; Communities; Comorbidity; Complement; Consensus; County; Data; Detection; Diabetes Mellitus; Diagnosis; Diagnostic; Diet; Digestive System Disorders; Disease; Disease Association; Early Diagnosis; Environment; Epidemiologic Studies; Epidemiology; Exclusion; Family member; Funding; General Population; Gluten; Goals; Health; Hepatitis; Hepatitis C; Human; Incidence; Individual; Inflammatory; Inpatients; Insulin-Dependent Diabetes Mellitus; Investigation; Knowledge; Life; Link; Medical; Medical Records; Military Personnel; Minnesota; Monoclonal gammopathy of uncertain significance; Morbidity - disease rate; Natural History; Outcome; Outpatients; Patients; Population; Population Study; Prevalence; Principal Investigator; Public Health; Recommendation; Records; Relative (related person); Research Personnel; Resources; Sampling; Screening procedure; Serologic tests; Serological; Serum; Symptoms; Testing; Time; United States National Institutes of Health; Work; Wyoming; abstracting; adverse outcome; base; cohort; computerized; disease diagnosis; epidemiologic data; experience; follow-up; gastrointestinal system; insight; mortality; novel; population based; programs; sample collection; symposium; young adult

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.

乳糜泻（CD）是消化系统最常见的慢性疾病之一，很容易发生 可以通过排除膳食麸质来治疗。在初步研究中，我们发现沉默性乳糜泻的患病率 接近 1% 的美国人口以及 4-10% 的家庭成员患有 CD 或 1 型疾病 糖尿病（T1DM）。有症状的 CD 可能是一种毁灭性的疾病，与病毒倍增有关。 死亡率和大量发病率，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 的情况下轻松检测出大量 CD 患者。 经典症状。然而，尚不清楚是否所有 CD 患者都会出现不良后果，还是仅少数患者会出现不良后果。 临床上明显的部分。了解沉默和沉默的长期结果至关重要 因此未经治疗，乳糜泻。我们将测试奥姆斯特德大批居民储存的血清 县，这是一个经过充分医学研究的人群，旨在识别那些患有无症状乳糜泻的人。我们已经建立了 临床诊断的 CD 患病率及其亲属和 T1DM 患者的患病率 这个社区的贫血症。这解决了未确诊的乳糜泻在以下人群中很常见的假设： 今天的一般人口。检验乳糜泻在 50 年前和现在一样普遍的假设 今天，从历史上一大群年轻人中采集的 50 岁血清中 CD 的患病率 对于可获得 45 年结果数据的人，将进行类似的分析。双方军方的结果 死亡率方面的队列已经建立，从而使我们能够检验未被发现的假设 乳糜泻最终与 45 年生存率下降有关。一旦那些有静音CD的人 在奥姆斯特德县确定，我们可以通过首先检查来确定乳糜泻的长期发病率 对于有或没有 CD 证据的受试者，在采样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测试疾病关联。第三，我们将确定发病率 军事队列使用 1996 年已经提取的数据。该项目对公众的意义 健康在于它将提供有关沉默性乳糜泻长期结果的新颖的综合信息 长期患病。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，这种疾病可能影响 1% 的美国人。