Epidemiology of coeliac disease in a single centre in Southern Derbyshire 1958–2014

Abstract

ObjectiveTo determine trends in diagnosis of coeliac disease (CD) in patients attending a single centre 1958–2014 and provide figures for prevalence and incidence in those born in Derby city over 4 decades. To explore a link between deprivation and prevalence and characteristics of CD in Asians.DesignAn unselected, consecutive series of 2410 adult patients with CD diagnosed in the catchment area of the Derby hospitals was identified. 1077 born within Derby city identified by postcodes was used to determine changes in prevalence and incidence over 4 decades. 191 patients were Asian. Population numbers were obtained from National Census information.ResultsIn the quinquennium 2010–2014, 20 times more patients were diagnosed than during 1975–1979. 27% were diagnosed at ≥60 years. A paucity of diagnoses in young men was observed. Women were diagnosed most often in age band ≥35<45, 15 years earlier than men. The largest increase in diagnosis rates occurred in young women and the elderly. In 2014, overall prevalence was 1:188; women 1:138. 4.6% of the variation was attributed to deprivation. Diagnosis rates in Asians increased markedly although only 5% were diagnosed at ≥60 years, much lower than for whites.ConclusionsThe dramatic increase in number of patients with CD presents challenges for follow-up and new models of care need to be explored. Healthcare workers should be alert to the diagnosis in young men and elderly Asians. A dedicated coeliac clinic is an excellent facility to increase diagnosis rates.

Review article: coeliac disease in later life must not be missed

“…Among the Asian population there is a dearth of diagnoses in later life. Only 5% of Asians were diagnosed in the Derby clinic at or over the age of 60 years which is far less than for whites . In a series from New Delhi, only 9% were diagnosed at the age of 50 years or more .…”

“…More realistic figures come from the coeliac disease clinic in Derby, UK, which is not a referral centre. Here, 28% and 21% were diagnosed by small intestinal biopsy at the ages of 60 years or more or 65 years and over, respectively . About 4% were diagnosed at or over the age of 80 years.…”

“…Coeliac disease is more common in females than males with an overall female to male ration of 2:1 in white populations . However, there was a paucity of diagnoses in young men < 20 years of age giving a ratio of 4:1.…”

Coeliac disease in Caucasian and South Asian patients in the North West of England

“…The orthodox view of coeliac disease is that it was particularly associated with patients of Celtic origin . However, diagnosis rates of coeliac disease, particularly amongst South Asian patients, have increased markedly compared to the reported rates in the 1970s .…”

Global epidemiology of celiac disease

“…Так, в Великобритании количество больных с впер-вые установленным диагнозом целиакии в пери-од с 2001 по 2005 г. в 8 раз превысило таковое по сравнению с пятилетним периодом конца 1980-х гг. [7,8], в период с 1993 по 2002 г. отмечено уве-личение заболеваемости с 6 до 13,3 на 100 тыс. [9].…”