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What are the Rates and Risk of Celiac Disease in Healthy U.S. Adults?

Celiac.com 08/06/2012 - Celiac disease seems to be on the rise in the United States, with recent population-based data suggest a sharp increase in rates over the last several decades.

A number of researchers hypothesize that such a rise might be due in part to disease triggers including inter-current illnesses, such as gastroenteritis, surgeries, and trauma.

Photo: CC--Ed YourdonBut just how common is celiac disease among the healthy adult population, and what, if any, do prior illnesses have to do with it? To get a better idea of actual rates and connections, a team of researchers recently conducted a study regarding the incidence and risk of celiac disease in healthy U.S. adults.

The research team included Mark S. Riddle, Joseph A. Murray and Chad K. Porter. For their study, they turned to data from active duty US military personnel, a largely healthy population with excellent medical diagnostic coding. The data offered a unique opportunity to spot trends in celiac disease and deployment-related risk factors.

The team used electronic medical encounter data, from 1999–2008, on active duty US military personnel. In all, they reviewed data for over 13.7 million person-years, to conduct a matched, nested case–control study describing the epidemiology and risk determinants of CD (based on ≥2 ICD-9 medical encounters).

Using this data, they were able to estimate incidence and duration of celiac-related medical care, and to employ conditional logistic regression to evaluate celiac disease risk following infectious gastroenteritis (IGE) up to 3 years before celiac diagnosis, while controlling for other risk factors.

They found a total of 455 incident cases of celiac disease, which they then age, gender, and time matched to 1,820 control subjects.

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They found that, from 1999 to 2008, cases of celiac disease increased five-fold from 1.3 per 100,000 to 6.5 per 100,000, with the highest rates of increase among those over 34 years of age. The average annual increase was 0.8 cases per 100,000.

They found a total of 172 episodes of IGE, 60.5% of which were viral in nature.

Using multivariate models, they found a strong association between IGE and CD was found (Odds ratio (OR): 2.06, 95% confidence interval (CI) 1.43, 2.97). Risk generally increased with temporal proximity to, and non-viral etiology of, exposure.

Other notable risk factors for CD in multivariate models were Caucasian race (OR: 3.1, P).

Rates of celiac disease in the US military are rising, particularly among those in the fourth and fifth decades of life and the rates seem higher than other population-based estimates.

The team noted a connection between prior IGE and risk of celiac disease, but they noted that they could not rule out possible IGE misclassification, and called for further study to better determine any links between pathogen-specific exposure to celiac disease, anti-gluten antibody development or symptom onset.

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2 Responses:

 
Albert
Rating: ratingfullratingemptyratingemptyratingemptyratingempty Unrated
said this on
13 Aug 2012 12:57:27 PM PDT
They can declare "healthy" person, when there is no reliable test for gluten sensitivity. I am lost there! I am on GF diet, however, I do not consider myself sick. Why they call it disease? Anyway, testing keep doctors busy; despite the fact that is no way to rule out gluten sensitivity.
Any argument? I don't think so!

 
Wayne C. Boswell
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said this on
08 Nov 2012 6:10:04 PM PDT
We cannot establish a valid rate on the basis of just those who happen to be lucky enough to at some point be properly diagnosed. I was diagnosed at age 47, but in retrospect I realized the condition had plagued me my entire life... including a 4 year hitch in the U.S. NAVY. I read somewhere shortly after my way-late diagnosis that in Italy, children are tested for celiac sprue when they start school. Sure you say... the condition is much more prevalent in Europe. Hey! We nearly all have a heredity line from Europe. Most U.S. celiacs go undiagnosed for decades, while the auto-immune reactions are slowly destroying their health. Yes, it gets my goat!




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Thank you for your reply, though it's not necessarily what I wanted to hear, it is what I was thinking.

you're lucky you dont catch colds. im the opposite i catch everything very easily and get alot sicker than whoever i caught it from and take much longer to get better.

Even one positive can be diagnostic. This is one: Gliadin deamidated peptide IgG 33.9. If unsure, a biopsy of the small intestine will provide definite confirmation. There is a control test to validate the other ones, but I don't see it there. What is does is validate the others by checking on the overall antibody levels. But it is to detect possible false negatives. A positive is a positive. I think your daughter has joined our club.

My daughter, almost 7 years old, recently had a lot of blood work done, her Dr is out of the office, but another Dr in the practice said everything looked normal. I'm waiting for her Dr to come back and see what she thinks. I'm concerned because there is one abnormal result and I can't find info to tell me if just that one test being abnormal means anything. The reason for the blood work is mainly because of her poor growth, though she does have some other symptoms. IgA 133 mg/dl Reference range 33-200 CRP <2.9 same as reference range Gliadin Deamidated Peptide IgA .4 Reference range <=14.9 Gliadin deamidated peptide IgG 33.9 Reference range <=14.9 TTG IgA .5 Reference range <=14.9 TTG IgG <.8 Reference range <=14.9

Just watch out. I just went to the expo in Schaumburg, IL, and ended up getting glutened. I realized afterward that I ate all these samples thinking they were gluten free, and they weren't. One company was advertising some sugar, and had made some cake, but then I realized.... How do I know if this contains any other ingredients that might have gluten? Did they make it with a blender or utensils that had gluten contamination? Makes me realize the only safe things would be packaged giveaways with gluten free labeling. My fault for not thinking things through. It was just too exciting thinking i could try it all and enjoy without worry.