The Epidemiology of Bile Acid Diarrhea in Denmark

IF 3.4 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology Pub Date : 2023-12-07 DOI:10.2147/clep.s442054

Martin L Kårhus, Anne-Marie Ellegaard, Matilde Winther-Jensen, Susanne Hansen, Filip K Knop, Line L Kårhus

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引用次数: 0

Abstract

Objective: Bile acid diarrhea (BAD) is a socially debilitating disease with frequent bowel movements, urgency, and fecal incontinence as the main symptoms. It is caused by excessive bile acid levels in the colon and is most commonly treated with bile acid sequestrants. It is estimated that 1– 2% of the population suffers from the disease, but only a fraction of these are properly diagnosed with the gold standard ⁷⁵selenium-homotaurocholic acid (SeHCAT) test. Here, we use nationwide registries to describe the demographic characteristics of individuals suffering from BAD in Denmark.
Methods: Since the International Classification of Diseases diagnosis code for BAD was not used until 2021, we identified the BAD population by referral to SeHCAT testing followed by a prescription of a bile acid sequestrant (colestyramine, colestipol or colesevelam) within 365 days. The study period was from 2003 to 2021.
Results: During the study period, a total of 5264 individuals with BAD were identified with large differences between the five regions in Denmark. The number of prescriptions of colestyramine and colesevelam, the number of SeHCAT tests, and the number of individuals diagnosed with BAD increased during the study period. The BAD population had more co-morbidities and more health care contacts as well as lower levels of education and income compared with age- and sex-matched controls from the general population.
Conclusion: Using the Danish registries, we identified a BAD population, which seems to be inferior in health care and socio-economic parameters compared with the Danish general population.

Keywords: Bile acid diarrhea, epidemiology, nationwide registries

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丹麦的胆汁酸腹泻流行病学

目的：胆汁酸腹泻（BAD）是一种使人衰弱的社会性疾病，主要症状为排便频繁、里急后重和大便失禁。它是由结肠中胆汁酸水平过高引起的，最常见的治疗方法是使用胆汁酸螯合剂。据估计，1%- 2% 的人口患有此病，但其中只有一小部分人能够通过黄金标准⁷⁵硒-高陶胆酸（SeHCAT）检测得到正确诊断。在此，我们利用全国性的登记资料来描述丹麦 BAD 患者的人口统计学特征：由于 BAD 的国际疾病分类诊断代码要到 2021 年才开始使用，因此我们通过转诊进行 SeHCAT 检测，并在 365 天内开具胆汁酸螯合剂（可乐定、可乐定或可乐司维兰）处方来确定 BAD 患者。研究时间为 2003 年至 2021 年：在研究期间，共发现了 5264 名胆汁淤积症患者，丹麦的五个地区之间存在很大差异。在研究期间，可乐定和可乐定的处方数量、SeHCAT 检测次数以及被诊断为 BAD 的人数都有所增加。与年龄和性别相匹配的普通人群对照组相比，BAD人群的合并疾病更多，接触的医疗服务更多，教育程度和收入水平也更低：通过丹麦登记，我们发现了一个胆汁酸腹泻人群，与丹麦普通人群相比，该人群的医疗保健和社会经济参数似乎较低：胆汁酸腹泻、流行病学、全国性登记

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Epidemiology Medicine-Epidemiology

CiteScore

6.30

自引率

5.10%

发文量

169

审稿时长

16 weeks

期刊介绍： Clinical Epidemiology is an international, peer reviewed, open access journal. Clinical Epidemiology focuses on the application of epidemiological principles and questions relating to patients and clinical care in terms of prevention, diagnosis, prognosis, and treatment. Clinical Epidemiology welcomes papers covering these topics in form of original research and systematic reviews. Clinical Epidemiology has a special interest in international electronic medical patient records and other routine health care data, especially as applied to safety of medical interventions, clinical utility of diagnostic procedures, understanding short- and long-term clinical course of diseases, clinical epidemiological and biostatistical methods, and systematic reviews. When considering submission of a paper utilizing publicly-available data, authors should ensure that such studies add significantly to the body of knowledge and that they use appropriate validated methods for identifying health outcomes. The journal has launched special series describing existing data sources for clinical epidemiology, international health care systems and validation studies of algorithms based on databases and registries.