Incidence and prevalence of celiac disease and dermatitis herpetiformis in the UK over two decades: population-based study

West, Joe and Fleming, Kate M. and Tata, Laila J. and Card, Timothy R. and Crooks, Colin J. (2014) Incidence and prevalence of celiac disease and dermatitis herpetiformis in the UK over two decades: population-based study. American Journal of Gastroenterology, 109 (5). pp. 757-768. ISSN 1572-0241

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Abstract

OBJECTIVES: Few studies have quantified the incidence and prevalence of celiac disease (CD) and dermatitis herpetiformis (DH) nationally and regionally by time and age groups. Understanding this epidemiology is crucial for hypothesizing about causes and quantifying the burden of disease. METHODS: Patients with CD or DH were identified in the Clinical Practice Research Datalink between 1990 and 2011. Incidence rates and prevalence were calculated by age, sex, year, and region of residence. Incidence rate ratios (IRR) adjusted for age, sex, and region were calculated with Poisson regression. RESULTS: A total of 9,087 incident cases of CD and 809 incident cases of DH were identified. Between 1990 and 2011, the incidence rate of CD increased from 5.2 per 100,000 (95% confidence interval (CI), 3.8-6.8) to 19.1 per 100,000 person-years (95% CI, 17.8-20.5; IRR, 3.6; 95% CI, 2.7-4.8). The incidence of DH decreased over the same time period from 1.8 per 100,000 to 0.8 per 100,000 person-years (average annual IRR, 0.96; 95% CI, 0.94-0.97). The absolute incidence of CD per 100,000 person-years ranged from 22.3 in Northern Ireland to 10 in London. There were large regional variations in prevalence for CD but not DH. CONCLUSIONS: We found a fourfold increase in the incidence of CD in the United Kingdom over 22 years, with large regional variations in prevalence. This contrasted with a 4% annual decrease in the incidence of DH, with minimal regional variations in prevalence. These contrasts could reflect differences in diagnosis between CD (serological diagnosis and case finding) and DH (symptomatic presentation) or the possibility that diagnosing and treating CD prevents the development of DH.

Item Type: Article
Keywords: Adolescent, Adult, Age Distribution, Aged 80 and over, Celiac Disease, epidemiology, Child, Preschool Databases, Factual Dermatitis Herpetiformis/*epidemiology, Female, Great Britain/epidemiology, Humans, Incidence Infant ,Linear Models, Male, Middle Aged, Poisson Distribution, Prevalence, Sex Distribution, Young Adult
Schools/Departments: University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine > Division of Epidemiology and Public Health
Identification Number: https://doi.org/10.1038/ajg.2014.55
Depositing User: Claringburn, Tara
Date Deposited: 26 Jan 2016 11:23
Last Modified: 14 Sep 2016 14:41
URI: http://eprints.nottingham.ac.uk/id/eprint/31372

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