Prevalence of celiac disease in Germany:A prospective follow-up study

作     者：Wolfgang Kratzer Monika Kibele Atilla Akinli Marc Porzner Bernhard O Boehm Wolfgang Koenig Suemeyra Oeztuerk Richard A Mason Ren Mao Mark H Haenle 

作者机构：Department of Internal Medicine Ⅰ University Hospital Ulm Department of Internal Medicine Ⅱ University Hospital Ulm Louis Stokes Cleveland Department of Veterans Affairs Medical Center Department of Gastroenterology the First Affiliated Hospital of Sun Yat-sen University 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2013年第19卷第17期

页      面：2612-2620页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Cross-sectional study Celiac disease Screening Prevalence Serology 

摘      要：AIM:To determine the prevalence of celiac disease in a randomly selected population sample. METHODS:A total of 2157 subjects (1036 males; 1121 females) participating in a population-based cross-sectional study underwent laboratory testing for tissue transglutaminase and antibodies to immunoglobulin A, endomysium and antigliadin. In a second step, all subjects who had been examined serologically were surveyed using a questionnaire that included questions specific to celiac disease. Subjects with positive antibody titers and those with histories positive for celiac disease then underwent biopsy. At the first follow up, antibody titers were again determined in these subjects and subjects were questioned regarding symptoms specific for celiac disease and disorders associated with celiac disease. The second follow up consisted of a telephone interview with subjects positive for celiac ***:Antibody tests consistent with celiac disease were reported in eight subjects, corresponding to an overall prevalence of 1:270 (8/2157). The prevalence among women was 1:224 and 1:518 in men. Classical symptoms were observed in 62.5% of subjects. Atypical celiac disease was present in 25.0%, and transient celiac disease in 12.5%. False-negative test results were returned in three subjects. This yields a sensitivity and specificity of 62.5% and 50.0%, respectively, for tissue transglutaminase immunoglobulin-A antibody; of 62.5% and 71.4% respectively, for endomysium antibody; and of 62.5% and 71.4%, respectively, for antigliadin ***:The prevalence rate in our collective lies within the middle tertile of comparable studies in Europe. The use of a single antibody test for screening purposes must be called into question.