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    Jefferson Adams
    Screening Study Shows Higher Prevalence for Celiac Disease
    Celiac.com 03/28/2011 - While rates of diagnosed celiac disease are less than 1 in 2,000 in the United States, screening studies in European and other populations have shown a much higher prevalence.
    A team of researchers recently set out to assess rates of celiac disease and the benefits of screening in the general adult population in certain geographically isolated areas.
    The research team included Kent D. Katz MD, Shahrooz Rashtak MD, Brian D. Lahr BS, MS, L. Joseph Melton III MD, Patricia K. Krause BS, MBA, Kristine Maggi PA-C, Nicholas J. Talley MD, PhD, and Joseph A. Murray MD.
    They are affiliated variously with the Wyoming Medical Center in Casper, Wyoming, the Department of Dermatology, the Division of Gastroenterology and Hepatology of the Department of Internal Medicine, the Division of Biostatistics, and the Division of Epidemiology in the Department of Health Sciences Research at the Mayo Clinic in Rochester, Minnesota.
    The team measured serum tissue transglutaminase antibodies (tTG-IgA) in adult volunteers at the annual Casper, Wyoming, Blue Envelope Health Fair blood draw. The team then checked endomysial IgA antibodies in those with positive tTG-IgA results.
    For those who tested positive for both screens, the team offered endoscopy with small bowel biopsy. All participants completed a short gastrointestinal (GI) symptom questionnaire.
    The team did blood tests on a total of 3,850 subjects, 34 of whom tested positive for both tTG and endomysial antibody (EMA) IgA.
    The team excluded three individuals who had been previously diagnosed with celiac disease, leaving 31 subjects, and making the total positive celiac serology in this community sample 0.8%.
    The team offered small bowel biopsy to those 31 subjects. They performed a total of 18 biopsies, with 17 patients (94%) showing at least partial villous atrophy.
    Symptoms reported by test subjects did not predict positive diagnosis. In fact, most subjects showed no symptoms, or else showed atypical symptoms.
    Serologic testing readily detects celiac disease in a general population. Screening results showed that undiagnosed celiac disease affects 1 in 126 individuals in this Wyoming community.
    Source:

    Am J Gastroenterol advance online publication 1 March 2011. doi: 10.1038/ajg.2011.21

    Jefferson Adams
    Are Celiac Disease Rates in China Higher Than Reported?
    Celiac.com 12/25/2013 - At present, the number of reported celiac disease cases is extremely low in China. 
    Until recently, celiac disease was considered to be rare in China. A team of researchers recently set out to compile an accurate estimate of rates of celiac disease in China.
    The research team included Juanli Yuan, Jinyan Gao, Xin Li, Fahui Liu, Cisca Wijmenga, Hongbing Chen, and Luud J. W. J. Gilissen. They are variously affiliated with the State Key Laboratory of Food Science and Technology, the College of Pharmaceutical Sciences, and the School of Life Sciences and Food Engineering, at Nanchang University in Nanchang, China, the Department of Genetics at the University Medical Centre Groningen ofUniversity of Groningen in Groningen, The Netherlands, with the Sino-German Joint Research Institute, Nanchang University, Nanchang, Jiangxi, China, and with the Plant Research International at Wageningen University & Research Centre in Wageningen, The Netherlands.
    The team used the MEDLINE database and four Chinese full-text databases (CNKI, CBM, VIP and WANFANG), as well as two HLA allele frequency net databases. along with the Chinese Statistics Yearbook databases, to review the literature for definite and suspected cases of celiac disease, the predisposing HLA allele frequencies, and information on gluten exposure in China.
    They performed meta-analysis by analyzing DQ2, DQ8 and DQB1*0201 gene frequencies and heterogeneity in populations from different geographic regions and ethnicities in China.
    They found that frequencies of the HLA-DQ2.5 and HLA-DQ8 haplotypes were 3.4% (95% confidence interval 1.3–5.5%) and 2.1% (0.1–4.1%), respectively. HLA-DQ2 and HLA-DQ8 antigen frequencies were 18.4% (15.0–21.7%) and 8.0% (4.5–11.4%), respectively.
    The frequency of the DQB1*0201 allele was 10.5% (9.3–11.6%), and the allele was more common in the northern Chinese than in the southern Chinese individuals.
    HLA haplotype data, in conjunction with increasing wheat consumption, strongly suggest that rates of celiac disease are far higher in China than currently reported.
    They suggest that the Chinese government, medical and agricultural research institutions, and food industries work together to increase awareness about celiac disease to prevent it from growing into a medical and societal burden.
    Source:
    PLOS ONE DOI: 10.1371/journal.pone.0081151

    Jefferson Adams
    Celiac.com 05/01/2014 - While estimates indicate that about 1% of the world's population is affected by celiac disease, it is thought to be uncommon in both India and Asia. However, very little study has been done on celiac disease in Asian nations.
    A team of researchers recently set out to estimate rates of celiac disease in the Indian population. The research team included G.K. Makharia, A.K. Verma, R. Amarchand, S. Bhatnagar, P. Das, A. Goswami, V. Bhatia, V. Ahuja, S. Datta Gupta, and K. Anand. They are affiliated with the Department of Gastroenterology and Human Nutrition at the All India Institute of Medical Sciences in New Delhi, India.
    For their cross sectional study, the team estimated rates of celiac disease in urban and rural populations in the National Capital Region in Delhi, India.
    For their estimate, they made door-to-door visits with a structured questionnaire, collecting socio-demographic data, and screening for features of celiac disease, namely chronic or recurrent diarrhea and, anemia. In children, they included short stature, and failure to thrive/gain weight.
    All respondents who screened positive for any of the above factors, and 10% of screen negative individuals received blood tests for the anti-tissue transglutaminase antibody.
    Those with positive blood tests were invited to undergo further evaluation including endoscopic biopsy. Diagnosis for celiac disease was made on the basis of a positive blood test, the presence of villous atrophy and/or response to gluten free diet.
    Overall, the team had 10,488 participants, just over 50% of which were male. A total of 5622 participants (53.6%) showed positive first screens. Of those, 2167 (38.5%) received blood test. The team also blood tested an additional 712 (14%) negative first screens.
    The team found a total celiac disease blood screen rate of 1.44%, with 95% confidence interval [CI] 1.22 1.69, and a total celiac disease rate of 1.04%, with 95% CI 0.85 1.25.
    The prevalence of celiac disease in this north Indian community is slightly over one percent, which is about the same as many western nations, and higher than generally recognized in India.
    Source:
    J Gastroenterol Hepatol. 2011 May;26(5):894-900. doi: 10.1111/j.1440-1746.2010.06606.x.

    Jefferson Adams
    Celiac.com 09/01/2014 - At present, the number of reported celiac disease cases in China is extremely low, and celiac disease is considered to be rare in that country. To determine the accuracy of this perspective, a team of researchers recently set out to compile an accurate estimate of rates of celiac disease in China.
    The research team included Juanli Yuan, Jinyan Gao, Xin Li, Fahui Liu, Cisca Wijmenga, Hongbing Chen, and Luud J. W. J. Gilissen. They are variously affiliated with the State Key Laboratory of Food Science and Technology, the College of Pharmaceutical Sciences, and the School of Life Sciences and Food Engineering, at Nanchang University in Nanchang, China, the Department of Genetics at the University Medical Centre Groningen of University of Groningen in Groningen, The Netherlands, with the Sino-German Joint Research Institute, Nanchang University, Nanchang, Jiangxi, China, and with the Plant Research International at Wageningen University & Research Centre in Wageningen, The Netherlands.
    The team reviewed the literature for certain and possible cases of celiac disease, the predisposing HLA allele frequencies, and information on gluten exposure in China. For the review, the team used the MEDLINE database, Chinese full-text databases CNKI, CBM, VIP and WANFANG, and two HLA allele frequency net databases, along with the Chinese Statistics Yearbook databases. They performed meta-analysis by analyzing DQ2, DQ8 and DQB1*0201 gene frequencies, and heterogeneity, in populations from different geographic regions and ethnicities in China.
    They found that frequencies of the HLA-DQ2.5 and HLA-DQ8 haplotypes were 3.4% (95% confidence interval 1.3–5.5%) and 2.1% (0.1–4.1%), respectively. HLA-DQ2 and HLA-DQ8 antigen frequencies were 18.4% (15.0–21.7%) and 8.0% (4.5–11.4%), respectively. The frequency of the DQB1*0201 allele was 10.5% (9.3–11.6%), and the allele was more common in the northern Chinese than in the southern Chinese individuals.
    HLA haplotype data, in conjunction with increasing wheat consumption, strongly suggest that rates of celiac disease are far higher in China than currently reported.
    The researchers suggest that the Chinese government, medical and agricultural research institutions, and food industries work together to increase awareness about celiac disease to prevent it from growing into a medical and societal burden.
    Source:
    PLOS ONE DOI: 10.1371/journal.pone.0081151

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