Less Hidden Celiac Disease, But More Americans Avoiding Gluten

Celiac.com 01/20/2017 - A team of researchers recently investigated trends in the prevalence of diagnosed celiac disease, undiagnosed celiac disease, and people without celiac disease avoiding gluten (PWAG) in the civilian non-institutionalized US population from 2009 to 2014.

The research team included Rok Seon Choung, MD, PhD, Aynur Unalp-Arida, MD, PhD, Constance E. Ruhl, MD, PhD, Tricia L. Brantner, BS, James E. Everhart, MD, and Joseph A. Murray, MD.

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They are variously affiliated with the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN; the Department of Health and Human Services, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD; Social & Scientific Systems, Inc., Silver Spring, MD; and with the Division of Cancer Epidemiology and Genetics, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.

Their team studied the occurrence of celiac disease and PWAG in the 2009 to 2014 National Health and Nutrition Examination Surveys. They tested serum of all participants aged 6 years or older from the National Health and Nutrition Examination Surveys from 2009 to 2014 for celiac disease serology at Mayo Clinic.

They also interviewed participants for a diagnosis of celiac disease, and the use of a gluten-free diet (GFD). They incorporated the design effects of the survey and sample weights into all statistical analyses.

Results
They found that, in the US general population, rates of celiac disease did not change significantly from 0.7% (95% CI, 0.6%-0.8%) in 2009 to 2010 to 0.8% (95% CI, 0.4%-1.2%) in 2011 to 2012 to 0.7% (95% CI, 0.3%-1.0%) in 2013 to 2014. However, rates of undiagnosed celiac disease decreased from 0.6% in 2009 to 2010 to 0.3% in 2013 to 2014.

In contrast, the prevalence of PWAG increased significantly from 0.5% (95% CI, 0.2%-0.9%) in 2009 to 2010 to 1.0% (95% CI, 0.6%-1.4%) in 2011 to 2012 to 1.7% (95% CI, 1.1%-2.4%) in 2013 to 2014 (P=.005 for trend).

Their data shows that, even though rates of celiac disease remained largely stable from 2009 to 2014, the percentage of individuals with hidden celiac disease decreased substantially.

Moreover, the proportion of individuals who follow a gluten-free diet without celiac disease rose sharply during that period. Long-term health consequences of a GFD warrant further investigation.

Source:

• Mayo Clinic Proceedings. DOI: http://dx.doi.org/10.1016/j.mayocp.2016.10.012