Celiac Disease Rates in China May be Higher than Reported

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.

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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.

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