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| 1 | Burden of celiac disease in the Mediterranean area显示文摘AIM: To estimate the burden of undiagnosed celiac disease (CD) in the Mediterranean area in terms of morbidity, mortality and health cost. METHODS: For statistics regarding the population of each country in the Mediterranean area, we accessed authoritative international sources (World Bank, World Health Organization and United Nations). The prevalence of CD was obtained for most countries from published reports. An overall prevalence rate of 1% cases/total population was finally estimated to represent the frequency of the disease in the area, since none of the available conf idence intervals of the reported rates significantly excluded this rate. The distribution of symptoms and complications was obtained from reliable reports in the same cohort. A standardized mortality rate of 1.8 was obtained from recent reports. Crude health cost was estimated for the years between symptoms and diagnosis for adults and children, and was standardized for purchasing power parity to account for the different economic prof iles amongst Mediterranean countries. RESULTS: In the next 10 years, the Mediterranean area will have about half a billion inhabitants, of which 120 million will be children. The projected number of CD diagnoses in 2020 is 5 million cases (1 million celiac children), with a relative increase of 11% compared to 2010. Based on the 2010 rate, there will be about 550 000 symptomatic adults and about 240 000 sick children: 85% of the symptomatic patients will suffer from gastrointestinal complaints, 40% are likely to have anemia, 30% will likely have osteopenia, 20% of children will have short stature, and 10% will have abnormal liver enzymes. The estimated standardized medical costs for symptomatic celiac patients during the delay between symptom onset and diagnosis (mean 6 years for adults, 2 years for children) will be about €4 billion (€387 million for children) over the next 10 years. A delay in diagnosis is expected to increase mortality: about 600 000 celiac patients will die in the next 10 years, with an excess of 44.4% vs age-and sexmatched controls. CONCLUSION: In the near future, the burden of CD will increase tremendously. Few Mediterranean countries are able to face this expanding epidemic alone. | Luigi Greco Laura Timpone Abdelhak Abkari Mona Abu-Zekry Thomas Attard Faouzi Bouguerrà Paskal Cullufi Aydan Kansu Dusanka Micetic-Turk Zrinjka Miak Eleftheria Roma Raanan Shamir Selma Terzic | 2011 | World Journal of Gastroenterology2011，17，45： | 2 |
| 2 | Seroprevalence of celiac disease among United Arab Emirates healthy adult nationals: A gender disparity显示文摘AIM:To determine celiac disease(CD)prevalence and associated manifestations or risk factors in healthy adult Emiratis.METHODS:It is a cross-sectional prospective study,recruiting 1197(573 women and 624 men)healthy Emiratis between September 2007 and April 2008among those who went to Al Ain Hospital to undertake the prenuptial examination.Test for anti-tissue transglutaminase(tTG)IgA antibodies was used for CD diagnosis.Subjects with positive results in the anti tTG antibodies assay were also tested for anti-endomysial(EMA)IgA antibodies.A structured interview was used to collect basic demographic and clinical recall data including:information on name,contact address,age,gender,education status,previous diagnosis of CD,diagnosis of CD in 1st degree relatives and history of'chronic diarrhea,anemia,headache,hepatitis,diabetes,tumor,and thyroid disorder'.RESULTS:Fourteen blood samples(1.17%;14/1197)were seropositive for CD.The latent CD seropositive patients were 13 women and 1 man and therefore the seroprevalence of CD was 1:86(14/1197)for adult Emiratis:1:44(13/573)for women and 1:624 for men.Binary logistic regression revealed that history of chronic anemia(crude OR=7.09;95%CI:2.32-21.61;P=0.003)and being a woman(OR=14.46;95%CI:1.89-110.91;P=0.001)were associated with CD seropositivity.Whereas,the thyroid disorder showed a positive association with CD seropositivity that approach statistical significance(OR=11.30;95%CI:1.32-96.95;P=0.09)and therefore was included in the multiple logistic regression analysis,which showed that CD seropositivity is independently associated only with history of chronic anemia(OR=4.58;95%CI:1.45-14.48;P=0.01)and being a woman person(OR=10.47;95%CI:1.33-82.14;P=0.026).CONCLUSION:Compared to men the CD seroprevalence among women was remarkably higher.The CD association with women and chronic anemia is of importance from a public health perspective. | Yousif A Abu-Zeid Waheeba S Jasem Benjamin Lebwohl Peter H Green Gehad ElGhazali | 2014 | World Journal of Gastroenterology2014，20，42： | 0 |
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