Celiac.com 04/29/2015 - In addition to people with celiac disease, a number of people in the U.S. do not have celiac disease, but avoid gluten (PWAG).

Photo: CC--AsboluvResearchers don't know much about racial disparities in the rates of celiac disease, and among those without celiac disease, but who avoid gluten. A team of researchers recently set out to investigate and describe racial differences in the prevalence of celiac disease and PWAG, and evaluate the trends of celiac disease in the non-institutionalized civilian adult population of the US between 1988 and 2012. The research team included Rok Seon Choung MD, PhD, Ivo C Ditah MD, MPhil, Ashley M Nadeau, Alberto Rubio-Tapia MD, Eric V Marietta MD, Tricia L Brantner, Michael J Camilleri MD, S Vincent Rajkumar MD, Ola Landgren MD, PhD, James E Everhart MD, MPH, and Joseph A Murray MD.

They are variously affiliated with the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA, Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA, the Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA, the Myeloma Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA, and with the Department of Health and Human Services, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA

The team conducted a population-based cross-sectional study using data from the National Health and Nutrition Examination Surveys (NHANES) from 1988 to 1994, 1999 to 2004, and 2009 to 2012. They tested serum samples from the NHANES participants for celiac serology, which included IgA tissue transglutaminase (tTG IgA), and then tested any abnormal findings for IgA endomysial antibodies.

They used an interviewer-administered questionnaire to gather information about patient adherence to a gluten-free diet.

Their review of NHANES 2009–2012 showed that adjusted rates of celiac disease were significantly higher (P<0.0001) in non-Hispanic whites (1.0%) than in non-Hispanic blacks (0.2%) and Hispanics (0.3%).

Meanwhile, blacks showed a significantly higher adjusted prevalence of PWAG of 1.2% (P=0.01), compared with Hispanics at 0.5% and whites 0.7%.

In adults aged 50 years and older, seroprevalence of celiac disease rose from 0.17% (95% confidence interval (CI) 0.03–0.33) in 1988–1994 to 0.44% (95% CI 0.24–0.81) in 2009–2012 (P<0.05).

Overall rates of celiac disease increased from 1988 to 2012, which is much more common in white Americans than in black Americans. Interestingly, black Americans make up a higher proportion of individuals maintaining a gluten-free diet in the absence of a celiac disease diagnosis.

It may be that celiac disease, or non-celiac gluten sensitivity, are more common in the black population that previously understood. Further study will undoubtedly shed some light on this issue.


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