The Black and White of Celiac Testing

[trents]

One of the questions that comes up from time to time on this forum is the prevalence of celiac disease among various racial groups. As it turns out, the question is complicated by differing responses to antibody testing between racial groups. This study done by the University of Alabama Birmingham sheds some light on that with regard to the differential results seen in the African American population vs. the white population: Black people with biopsy confirmed celiac disease often have negative blood test results.

An excerpt: 

Eighty percent of Black patients with biopsy-confirmed celiac disease in the registry had TTG test results that were less than the upper limit of normal, compared to about 9 percent of non-Hispanic white patients in the registry. The upper limit of normal is the highest level at which a test result is still considered in the normal range. Additionally Black patients were much less likely to have been tested for the genes associated with celiac disease.

The high sensitivity of the TTG test is called into question by the findings in the registry, Cartee said, adding that 5 percent of the patients in the registry self-reported being Black. “These patients are more likely to have [serology]-negative disease,” she said.

Black patients in the registry were also more likely than non-Hispanic whites to have a greater Body Mass Index (BMI) at diagnosis. “In classic celiac disease, we tend to think of patients as having low or low normal BMI,” Cartee said. “However, with the US obesity epidemic, and then changing clinical presentation of celiac disease, we are seeing higher BMI as a diagnosis.”

Edited July 7, 2022 by trents

[Scott Adams]

This is very interesting research, and we'll likely summarize it.