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. 2017 Apr 1;4(1):e000137.
doi: 10.1136/bmjgast-2017-000137. eCollection 2017.

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

Geoffrey K T Holmes  1 , A Muirhead  2
Affiliations

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

Geoffrey K T Holmes et al. BMJ Open Gastroenterol. .

Abstract

Objective: To 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.

Design: An 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.

Results: In 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.

Conclusions: The 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.

Keywords: AUDIT; COELIAC DISEASE; EPIDEMIOLOGY.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Summary of study populations.
Figure 2
Figure 2
Numbers per year for 2410 patients with CD diagnosed in Derby hospitals 1958–2014. CD, coeliac disease.
Figure 3
Figure 3
Diagnoses in Derby hospitals by biopsy (1689) and serology (721) in successive quinquennia for patients with CD. CD, coeliac disease.
Figure 4
Figure 4
Age at diagnosis of CD in 2410 patients by biopsy (1689) and Serology (721) in Derby hospitals. CD, coeliac disease.
Figure 5
Figure 5
Diagnoses of 2410 patients with CD by biopsy (1689) and serology (721) in Derby hospitals in age bands. CD, coeliac disease.
Figure 6
Figure 6
Diagnoses of CD per 1000 of the population for 2410 patients by biopsy (1689) and serology (721) in Derby hospitals by gender and age bands.
Figure 7
Figure 7
Scatter plot of prevalence of CD and IMD by LSOA. CD, coeliac disease; IMD, Indices of Multiple Deprivation; LSOA, Lower Super Output Area.
Figure 8
Figure 8
Diagnoses in 191 Asians with CD in Derby hospitals in successive quinquennia.
Figure 9
Figure 9
Diagnoses in 191 Asians with CD in Derby hospitals in age bands. CD, coeliac disease.
See this image and copyright information in PMC

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