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.

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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.

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