Exploring the risk factors for differences in the cumulative incidence of coeliac disease in two neighboring countries: the prospective DIABIMMUNE study

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• 作者：K&auml ; rt Simre^a ; ^b ; Oivi Uibo^b ; ^c ; Aleksandr Peet^b ; ^c ; Vallo Tillmann^b ; ^c ; Pille Kool^c ; Anu-Maaria H&auml ; m&auml ; l&auml ; inen^d ; Taina H&auml ; rkö ; nen^e ; ^f ; Heli Siljander^e ; ^f ; Suvi Virtanen^g ; ^h ; ⁱ ; Jorma Ilonen^j ; Mikael Knip^e ; ^f ; ⁱ ; ^k ; Raivo Uibo^a ; ^{raivo.uibo@ut.ee" class="auth_mail" title="E-mail the corresponding author} ; The DIABIMMUNE Study GroupMikael Knip^a ; Katriina Koski^b ; Matti Koski^b ; Taina H&auml ; rkö ; nen^a ; Heli Siljander^a ; Samppa Ryh&auml ; nen^a ; Anu-Maaria H&auml ; m&auml ; l&auml ; inen^c ; Anne Ormisson^d ; Aleksandr Peet^e ; Vallo Tillmann^e ; Valentina Ulich^f ; Elena Kuzmicheva^f ; Sergei Mokurov^f ; Svetlana Markova^g ; Svetlana Pylova^g ; Marina Isakova^h ; Elena Shakurova^h ; Vladimir Petrovⁱ ; Natalya V. Dorshakova^j ; Tatyana Karapetyan^j ; Tatyana Varlamova^j ; Jorma Ilonen^k ; ^l ; Minna Kiviniemi^k ; Kristi Alnek^m ; Helis Janson^m ; Raivo Uibo^m ; Erika von Mutiusⁿ ; Juliane Weberⁿ ; Helena Ahlfors^o ; Henna Kallionp&auml ; &auml ; ^o ; Essi Laajala^o ; Riitta Lahesmaa^o ; Harri L&auml ; hdesm&auml ; ki^o ; Robert Moulder^o ; Janne Nieminen^p ; Terhi Ruohtula^p ; Outi Vaarala^p ; Hanna Honkanen^q ; Heikki Hyö ; ty^q ; Anita Kondrashova^q ; Sami Oikarinen^q ; Hermie J.M. Harmsen^r ; Marcus C. De Goffau^r ; Gjal Welling^r ; Kirsi Alahuhta^s ; Suvi M. Virtanen^s
• 关键词：Breastfeeding ; Coeliac disease ; Early feeding ; Early infections
• 刊名：Digestive and Liver Disease
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：48
• 期：11
• 页码：1296-1301
• 全文大小：570 K

文摘

During the last several decades the prevalence of coeliac disease (CD) has increased worldwide.

Aim

r0010">To compare the cumulative incidence of CD between Estonian and Finnish children and to identify the risk factors.

Materials and methods

r0015">Children were recruited as part of the DIABIMMUNE Study. In the birth cohort (BC) 258 children from Estonia and 305 from Finland, and in the young children's cohort (YCC) 1363 and 1384 children were followed up, respectively. The diagnosis of CD was made in accordance with the ESPGHAN guidelines–the presence of IgA-tTG antibodies and small bowel villous atrophy.

Results

r0020">During the study period 29 children developed CD. The cumulative incidence of CD was significantly higher in Finland (0.77% vs 0.27%; P = 0.01). No difference was seen between the children with CD and the controls in the duration of breastfeeding or the age at cereal introduction. The BC children with CD had had significantly more episodes of infections with fever by the age of 12 months compared to the controls (3.4 vs 1.4; P = 0.04).

Conclusion

r0025">The 5-year cumulative incidence of childhood CD is significantly higher in Finland than in Estonia. Sequential infections early in life may increase the risk for developing CD.