RESUMO
BACKGROUND & AIMS: Celiac disease is one of the most common diseases worldwide, with an apparent trend of increasing prevalence. We investigated the prevalence of celiac disease in children in Italy in 2015-2016 and compared that with data from 25 years ago. METHODS: We screened 4570 children (5-11 years old, 80.1% of the eligible population) from metropolitan areas of Ancona and Verona for HLA genes associated with increased risk of celiac disease, and for total serum levels of IgA and IgA class anti-tissue transglutaminase in HLA positives. Diagnoses of celiac disease were confirmed by detection of anti-endomysial antibody and analysis of intestinal biopsies. The prevalence of celiac autoimmunity and celiac disease were calculated and compared with values from the same geographical area during the years 1993-1995, after adjustment for the different diagnostic algorithm. RESULTS: We identified 1960 children with celiac disease-associated haplotypes (43% of children screened; 95% CI, 40.8%-45.2%). The prevalence of celiac disease autoimmunity in the HLA-positive subjects was 96/1706 (5.62%; 95% CI, 4.53%-6.71%) and 54 of these children satisfied the diagnostic criteria for celiac disease. In the eligible population there were other 23 known cases of celiac disease. The overall estimated prevalence of celiac disease was 1.58% (95% CI, 1.26%-1.90%); this value is significantly higher than the 1993-1995 adjusted prevalence (0.88%; 95% CI, 0.74%-1.02%). CONCLUSIONS: We found the prevalence of celiac disease in children in Italy to be greater than 1.5%; this value has increased significantly over the past 25 years. Studies are needed to determine the causes of this large increase.
Assuntos
Doença Celíaca , Autoanticorpos , Doença Celíaca/epidemiologia , Criança , Pré-Escolar , Humanos , Imunoglobulina A , Itália/epidemiologia , Prevalência , Instituições Acadêmicas , TransglutaminasesRESUMO
We performed a cross-sectional study. In spring 2019, 1,594 students (mean age 12.87 years) completed a questionnaire on gastrointestinal symptoms, smartphone use, Quality of Life (QoL), dietary habits, and physical activity. Based on the Rome IV criteria, 30.9% of participants met the symptom-based criteria for FGIDs and 8.9% experienced ≥2 disorders simultaneously. Well-being was less frequently reported by children with FGIDs than others (29.0% vs. 48.2%; p < 0.001). Participants addicted to smartphones reported low than others well-being (18.0% vs. 25.8%; p < 0.001), they also showed higher prevalence of FGIDs [Odds Ratio (OR), 1.98; 95% Confidence Interval (CI), 1.47-2.68; p < 0.001]. Among dietary habits, skipping breakfast (OR, 1.50; 95% CI, 1.09-2.05; p = 0.01) and low fruit consumption (OR, 1.66; 95% CI, 1.172.36; p = 0.005) were more frequent in participants with FGIDs. FGIDs are common in pediatric populations. FGIDs have an impact on QoL. Some dietary habits and physical activity are associated with these disorders. Smartphone addiction was found to be associated with FGIDs.