Epidemiology Of Celiac Disease Research Articles

Epidemiology of Celiac Disease in Western Iran during 2019-2021.

Celiac disease is a growing global public health concern. This epidemiological study is aimed at determining the prevalence of celiac disease in Kermanshah, Western Iran, from 2019 to 2021, as well as the frequency of gastrointestinal and nongastrointestinal manifestations associated with the disease. In this cross-sectional study, the medical records of all patients with a confirmed diagnosis of celiac disease between 2019 and 2021 were reviewed. The average population during the study period was 2,058,545. A researcher-developed checklist was used as the data collection tool, and descriptive statistics were employed for data analysis. During the study period, there were 113 patients diagnosed with celiac disease, with a mean age of 29.1 ± 16.6 years. The three-year prevalence of celiac disease was 5.49 (95% CI: 5.17-5.82) per 100,000 population. Among these patients, 70% (n = 78) was female. The most common gastrointestinal manifestations of the disease were abdominal pain (77.8%), constipation (59.3%), and diarrhea (54.9%). Iron-deficiency anemia (64.6%) and vitamin D3 deficiency (46.1%) were the most common nongastrointestinal manifestations. Growth retardation was observed in 39.0% of patients. This study demonstrated a higher prevalence of celiac disease in Kermanshah compared to global statistics. Given the association of celiac disease with other conditions such as diabetes, irritable bowel syndrome, growth retardation, and iron-deficiency anemia, healthcare providers should consider screening patients for celiac disease. Furthermore, community-based education is crucial in raising awareness about the significance of adhering to a proper diet and reducing wheat consumption.

Epidemiology of Celiac Disease in Northern Morocco in 2018–2021: A Descriptive Cross-Sectional Study

Celiac disease is an autoimmune disease caused by gluten. This retrospective cross-sectional study with descriptive and analytical aims was conducted over three years, from 2018 to 2021. The participants were 280 patients diagnosed with celiac disease registered in the Gluten Intolerant and Allergic Association of the North in the Tangier-Tetouan-Al Hoceima region. The prevalence and incidence of celiac disease in this region were 1/135 and 1/253, respectively. The average age was 21.18 ± 1.13, and the first symptoms appeared between 10 and 25 years. The data showed a female predominance of 68% versus 32% for males, with a male/female sex ratio of 0.45. The clinical signs of celiac disease manifested more in gastrointestinal symptoms. This study obtained data on 22.6% of microcytic hypochromic anemia patients and 40.7% of Helicobacter pylori infections. In addition to celiac disease, the patients showed other pathologies with different rates: repeated spontaneous abortions (2.14%), type 1 diabetes mellitus (1.42%), autism (1.42%), dermatitis herpetiformis (0.72%), cancer(0.72%), and epilepsy (0.35%). Serologically, anti-transglutaminase antibodies were positive in 47.2% of patients. Analyses of histological data from intestinal biopsies from 141 patients were positive in 50.8% of patients. There was a minor correlation between the serological profile and the degree of atrophy.

Epidemiology of Celiac Disease in Northern Morocco in 2018–2021: A Descriptive Cross-Sectional Study

Celiac disease is an autoimmune disease caused by gluten. This retrospective cross-sectional study with descriptive and analytical aims was conducted over three years, from 2018 to 2021. The participants were 280 patients diagnosed with celiac disease registered in the Gluten Intolerant and Allergic Association of the North in the Tangier-Tetouan-Al Hoceima region. The prevalence and incidence of celiac disease in this region were 1/135 and 1/253, respectively. The average age was 21.18 ± 1.13, and the first symptoms appeared between 10 and 25 years. The data showed a female predominance of 68% versus 32% for males, with a male/female sex ratio of 0.45. The clinical signs of celiac disease manifested more in gastrointestinal symptoms. This study obtained data on 22.6% of microcytic hypochromic anemia patients and 40.7% of Helicobacter pylori infections. In addition to celiac disease, the patients showed other pathologies with different rates: repeated spontaneous abortions (2.14%), type 1 diabetes mellitus (1.42%), autism (1.42%), dermatitis herpetiformis (0.72%), cancer(0.72%), and epilepsy (0.35%). Serologically, anti-transglutaminase antibodies were positive in 47.2% of patients. Analyses of histological data from intestinal biopsies from 141 patients were positive in 50.8% of patients. There was a minor correlation between the serological profile and the degree of atrophy.

Review article: Epidemiology of coeliac disease.

Coeliac disease is an immune-mediated disease caused by ingestion of gluten in genetically susceptible individuals. Coeliac disease has been thought to affect mainly people of European origin but subsequently many studies revealed that it affects people living in North America, Oceania, South America, Asia as well as Africa. The global pooled seroprevalence and prevalence of biopsy-confirmed coeliac disease are 1.4% and 0.7% respectively. The pooled incidence rates in women and men are 17.4 (95% CI: 13.7-21.1) and 7.8 (95% CI: 6.3-9.2) per 100000 person-years respectively. The systematic reviews, based on many population-based data, suggest that both the prevalence and the incidence of coeliac disease has increased over past three decades, which may be attributable not only to an increase in the detection rate (improvement in diagnostic tests, simplification of diagnostic criteria and increase in awareness about the disease) but also because of modernisation and globalisation related changes in the dietary practices including increase in the use of convenience food and dietary gluten. In addition to genetic factors, while there are many environmental risk factors, including age at the first introduction of gluten, breastfeeding, caesarean section, exposure to antibiotics and gut microbiome; the amount of gluten ingestion during early part of life, however, has been shown to increase the risk of coeliac disease, and this is relevant from the point of view of primary prevention. In this review, we have reviewed and summarised the literature, up till year 2021, related to the global and continent-wise epidemiology and risk factors associated with coeliac disease.

Docking of peptide candidates to HLA-DQ2 and HLA-DQ8 basket as a tool for predicting potential immunotoxic peptides toward celiac diseased people

Cereal food products susceptible to generate immunotoxic peptides play a key role in the epidemiology of celiac disease and associated non IgE-mediated gluten intolerance disorders. The specific recognition by the basket of the HLA-DQ2 and HLA-DQ2 serotype groups of the corresponding immunotoxic peptides, triggers a cascade of molecular recognition events that lead to the inflammatory mechanisms responsible for the erosion of the villi covering the intestinal mucosa, currently observed in the severe forms of celiac disease. Accordingly, different in silico approaches have been proposed to predict the possible occurrence of immunotoxic peptides or immunotoxic-like peptides in food proteins of plant origin and, especially, of edible cereals, to prevent the consumption of deleterious food products by celiac disease suffering people. Among these approaches, the docking of putative imunotoxic-like peptides to the HLA-DQ2 and HLA-DQ8 basket consists of an interesting tool, especially when coupled to the bioinformatic research for amino acid sequence identities with genuine immunotoxic peptides from the gliadin and glutenin proteins already identified in gluten-containing cereals. However, the specificity of the DQ2- and DQ8-peptides has to be checked since some promiscuity has been observed among the immunotoxic peptides concerning their HLA-DQ2/HLA-DQ8-binding specificity. Docking experiments performed with a series of 26 genuine immunotoxic peptides from gluten-containing cereals (wheat, oat, barley, rye) were compared to the glutamine/proline-containing peptides from the non-gluten corn and rice cereals, for their HLA-DQ2/HLA-DQ8-binding capacity. None of the peptides from non-gluten cereals was able to completely bind the HLA-DQ2/HLA-DQ8 basket whereas all of the 26 genuine immunotoxic peptides from the gluten-containing cereals become adequately bound to the HLA-DQ basket, even though some promiscuity occurred between the DQ2- and DQ8-specific peptides. Docking to the HLA-DQ2/HLA-DQ8 serotypes thus consists of a relevant tool to predict the immunotoxic propensity of food proteins toward celiac disease suffering people, provided their sequence are known.

Breaking bread!

Humankind has existed for 2·5 million years but only in the past 10 000 years have we been exposed to wheat. Therefore, it could be considered that wheat (gluten) is a novel introduction to humankind's diet! Prior to 1939, the rationing system had already been devised. This led to an imperative to try to increase agricultural production. Thus, it was agreed in 1941 that there was a need to establish a Nutrition Society. The very roots of the Society were geared towards necessarily increasing the production of wheat. This goal was achieved and by the end of the 20th century, global wheat output had expanded by 5-fold. Perhaps, as a result, the epidemiology of coeliac disease (CD) or gluten sensitive enteropathy has changed. CD now affects 1 % or more of all adults. Despite this, delays in diagnosis are common, for every adult patient diagnosed approximately three-four cases are undetected. This review explores humankind's relationship with gluten, wheat chemistry, the rising prevalence of modern CD and the new entity of non-coeliac gluten or wheat sensitivity. The nutritional interventions of a low fermentable oligo-, di- and mono-saccharides and polyols diet and gluten-free diet (GFD) for irritable bowel syndrome and the evidence to support this approach (including our own published work) are also reviewed. There appears to be a rising interest in the GFD as a 'lifestyler', 'free from' or 'clean eater' choice, causing concern. Restrictive diets may lead to potential nutritional implications, with long-term effects requiring further exploration.

Small Intestine.

Introduction: While recent studies have suggested that there might be an association between eosinophilic esophagitis (EoE) and celiac disease, there is a lack of studies on non-EoE eosinophilic gastrointestinal diseases (EGIDs) and celiac disease. We sought to determine the relationship between eosinophilic gastroenteritis (EoGE) and eosinophilic colitis (EoC), and celiac disease and describe the epidemiology of individuals with EoGE and EoC with co-existent celiac disease in the United States (US), utilizing a large population-based database. Methods: We queried a commercial database (Explorys Inc, Cleveland, OH), an aggregate of electronic health record data from 26 major integrated US healthcare systems from 1999 to May 2017. We identified an aggregated patient cohort of eligible patients with EoGE, EoC and concomitant celiac disease between May 2012 and May 2017, based on Systematized Nomenclature Of Medicine - Clinical Terms (SNOMED-CT). We calculated the prevalence of celiac disease in EoGE and EoC, among different patient groups. Results: Of the 35,795,250 individuals in the database active between May 2012 and May 2017, we identified 1,440 and 800 patients with EoGE and EoC respectively, and 84,040 patients with celiac disease. The overall 5-year prevalence rates of EoGE, EoC and celiac disease were 4/100,000, 2.2/100,000 and 234.8/100,000 persons respectively. 50 patients with EoGE also had concomitant celiac disease with the overall prevalence of celiac disease in EoGE being 3.5% (Figure 1) with an odds ratio (OR) of 15.37 (95% CI: 11.60-20.39, p < 0.0001) compared to individuals without eosinophilic gastrointestinal diseases. 30 patients with EoC also had concomitant celiac disease with the overall prevalence of celiac disease in EoC being 3.7% (OR 16.03; 95% CI: 11.13-23.08, p < 0.0001). The prevalence of celiac disease was higher in females vs males in EoGE (OR 1.11; 95% CI: 0.62-1.97, p=0.7310). Celiac disease presented predominantly in the Caucasian population in both EoGE (80%) and EoC (100%).Figure: Prevalence (%) of celiac disease in Eosinophilic Gastroenteritis (EoGE) and Eosinophilic Colitis (EoC).Conclusion: In this large population-based study, we found that the estimated 2012-2017 prevalence rates of celiac disease in EoGE and EoC are 3.5% and 3.7% respectively. This is one of the first large epidemiology studies that has demonstrated a significant association between celiac disease and non-EoE EGIDs. Further studies are needed to understand the mechanism of association between these disorders.

The Epidemiology of Celiac Disease in Eosinophilic Esophagitis in the United States from 2012 to 2017: Results From a Population-Based National Study

The Epidemiology of Celiac Disease in Eosinophilic Esophagitis in the United States from 2012 to 2017: Results From a Population-Based National Study

Epidemiology of coeliac disease in a single centre in Southern Derbyshire 1958–2014

ObjectiveTo determine trends in diagnosis of coeliac disease (CD) in patients attending a single centre 1958–2014 and provide figures for prevalence and incidence in those born in Derby city over...

Coeliac disease in the 21st century: paradigm shifts in the modern age.

The epidemiology of coeliac disease (CD) is changing. Presentation of CD with malabsorptive symptoms or malnutrition is now the exception rather than the rule and, it now affects those underweight and overweight equally. In concert with these epidemiological shifts, the incidence of CD is increasing. These changing patterns of disease presentation are challenging traditional management paradigms, and clinicians now need to adapt to these changes and respond to the demands of an increasingly well-informed consumer population. This article aims to provide historical context to the epidemiological changes in CD, which provides context to direct future research. Changing definitions and diagnostic paradigms are complicating the management of CD. The gold standard of diagnosis, treatment goals, guidelines for follow-up, and the role of population screening in CD remain controversial and unresolved. Although the patient population is interested in new treatments for CD and alternatives to a gluten-free diet, most therapies are not yet widely available or sufficiently researched, and our understanding of the natural history of CD is limited despite a number of retrospective and population-based studies. The management of asymptomatic CD has only recently been examined despite up to half of patients now presenting with no or minimal symptoms. There is surprisingly little evidence to resolve many of these issues, and only with robust prospective studies will our understanding of the true natural history of coeliac disease be clarified.

Epidemiology of Celiac Disease in Slovakia: Life Conditions of Celiac Disease Patients in Slovakia

Celiac disease (CD) is a chronic autoimmune disorder, elicited by gluten and related prolamines, with gluten dependant clinical manifestation in genetically susceptible individuals, with specific antibodies, HLA haplotyps and enteropathy. In Slovakia epidemiology situation of patients with diagnosed CD was being repeatedly surveyed. Patient with CD in Slovakia has possibility for prescriptions up to 50 specific gluten free products, partially covered by health insurance.

The new epidemiology of celiac disease.

The prevalence of celiac disease (CD) varies greatly, but several reports have shown that CD is increasing in frequency in different geographic areas. The increase in prevalence can be partially attributed to the improvement in diagnostic techniques and disease awareness; however the equally well documented rise in incidence in the last 30-40 years cannot be so easily explained. The new epidemiology of CD is now characterized by an increase of new cases in the historical CD areas (northern Europe and the United States) and more interestingly in a spread of the disease in new regions (Asian countries). A significant change in diet habits, particularly in gluten consumption as well as in infant feeding patterns are probably the main factors that can account for these new trends in CD epidemiology.

Epidemiology of Coeliac Disease and Comorbidity in Norwegian Children

The aim of this study was to describe the occurrence of clinically diagnosed coeliac disease in children ages 0 to 12 years in Norway, including regional variation and coexisting type 1 diabetes mellitus, thyroid disease, and Down syndrome. The Norwegian Patient Register (NPR) contains individual-level hospital data from 2008 onward. Small-bowel biopsies for establishing the coeliac disease diagnosis are only performed at public hospitals reporting to the NPR. Data on all hospital contacts during 2008-2011 when a diagnosis of coeliac disease was registered were retrieved from the NPR for patients born between 1999 and 2011, allowing estimation of the proportion registered with coeliac disease at ages 0 to 12 years in a cohort study. A total of 3006 individuals (58.2% girls) were recorded as having coeliac disease among 797,360 children, corresponding to a proportion of 3.8/1000 (95% confidence interval [CI] 3.7-3.9/1000) children, 4.5 (CI 4.3-4.7) among girls and 3.1 (CI 2.9-3.3/1000) among boys (P < 0.001). The proportion increased with age up to approximately 6 years and was 5.0/1000 (CI 4.5-5.6) at the age of 12 years, and was slightly higher in the south/west (3.9/1000) as compared to the middle/north (3.5/1000) regions of Norway (P = 0.013). A total of 214 of 3006 (7.1%) patients with coeliac disease were registered with coexisting conditions: type 1 diabetes mellitus (n = 142, 4.7%), Down syndrome (n = 47, 1.6%), or thyroid disease (n = 41, 1.4%). In this first nationwide study of clinically diagnosed coeliac disease in Norwegian children, we found a high occurrence, comparable with that in Sweden. Comorbidity was common, but routine screening of high-risk groups contributed to a limited number of cases.

Case Finding for Celiac Disease Is Okay, But Is It Enough?

Case Finding for Celiac Disease Is Okay, But Is It Enough?

The epidemiology of coeliac disease in South Wales: a 28-year perspective

ObjectivesThe diagnosis of coeliac disease (CD) has increased in frequency, particularly since the accuracy of serological antibody testing has improved. Previous studies from South Wales have shown an increase in...

Geographic trends and risk of gastrointestinal cancer among patients with celiac disease in Europe and Asian-Pacific region.

Celiac disease is an autoimmune disorder that affects genetically predisposed individuals upon the ingestion of gluten. It is now considered one of the most common genetic disorders in Europe and Asian Pacific region with a prevalence of up to 2.67% of the population. The true prevalence of celiac disease may still be underestimated. Studies remain limited by sample size and selection bias. Celiac disease predisposes to the development of gastrointestinal malignancies, especially lymphomas and small bowel adenocarcinoma. The risk of developing a celiac disease associated malignancies remains uncertain, despite numerous studies. In Middle Eastern countries, the literature regarding celiac disease has expanded significantly in recent years. These studies reported have largely concentrated on the epidemiology of Celiac disease and there is an absolute and relative paucity of published research regarding celiac disease associated malignancy. The aim of this article is to review the current literature and evaluate the risk of gastrointestinal malignancies among patients with celiac disease and then review studies from the Asian Pacific region of the world.

New Clues in Celiac Disease Epidemiology, Pathogenesis, Clinical Manifestations, and Treatment

Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten in genetically susceptible individuals. It is one of the most common lifelong disorders on a worldwide basis. Celiac enteropathy is the final consequence of an abnormal immune reaction, showing features of both an innate and an adaptive response to gluten prolamins. The clinical spectrum is wide, including cases with either typical intestinal or atypical extraintestinal features, and silent forms. The only available treatment consists in dietary exclusion of grains containing gluten. New pharmacological treatment are currently under scrutiny.

History of gluten and its effects on celiac disease

The global prevalence of celiac disease is of one person per 250 inhabitants. The disease is induced by gluten, a peptide contained in wheat, rye and barley that during small intestinal digestion generates smaller peptides. Some of these are resistant to hydrolysis and cross through the epithelium into the mucosa, inducing a cascade of immune reactions leading to the appearance of the disease in susceptible individuals. Gluten appeared as a consequence of agricultural practices initiated 10000 years ago in the Fertile Crescent of southwest Asia. Celiac disease epidemiology is complicated since consumption of gluten differs depending on the origin of populations. Treatment of celiac disease consists of withdrawing gluten from the diet, a task that becomes difficult in the long term. The concept of gluten-free food has changed along time. This article updates the concept of celiac disease, the history of gluten consumption in the world, the characteristics of a gluten free diet and the difficulties to adhere to it.

El gluten: Su historia y efectos en la enfermedad celíaca

The global prevalence of celiac disease is of one person per 250 inhabitants. The disease is induced by gluten, a peptide contained in wheat, rye and barley that during small intestinal digestion generates smaller peptides. Some of these are resistant to hydrolysis and cross through the epithelium into the mucosa, inducing a cascade of immune reactions leading to the appearance of the disease in susceptible individuals. Gluten appeared as a consequence of agricultural practices initiated 10000 years ago in the Fertile Crescent of southwest Asia. Celiac disease epidemiology is complicated since consumption of gluten differs depending on the origin of populations. Treatment of celiac disease consists of withdrawing gluten from the diet, a task that becomes difficult in the long term. The concept of gluten-free food has changed along time. This article updates the concept of celiac disease, the history of gluten consumption in the world, the characteristics of a gluten free diet and the difficulties to adhere to it.

Diagnosis and clinical presentations of celiac disease: a multicenter study

Ample use of serological markers of high sensitivity and specificity led to relevant changes in the epidemiology of celiac disease. The impact of these changes in our country is poorly known. To assess the diagnostic procedures, clinical presentations and follow up of celiac disease as conducted in current pediatric practice. A multicentric retrospective study of patients diagnosed between 2000 and 2005 in five pediatric hospitals in Santiago, Chile. Data was obtained from clinical records, recorded in electronic spreadsheets and analyzed by descriptive statistics. Seventy four of 83 identified patients fulfilled the inclusion criteria and were analyzed. Mean time to reach the diagnosis was 2.1 years. Cases younger than 10 years presented digestive manifestations such as chronic diarrhea and abdominal distension. Twenty one percent of older patients had atypical presentations (mainly short stature, refractory anaemia). Ten percent of cases were screened because a first degree relative had celiac disease. All patients had significant duodenal/jejunal lesion. IgA-antiendomysial antibodies (n =65) and IgA-antigliadin antibodies (n =23) were the most commonly used screening tests used but often, they were not available for follow up. A second biopsy was planned in all patients but only 26 had it due to repeated dietary transgressions, often due to unnoticed consumption of gluten in poorly labeled products. Digestive manifestations were the main presentation form for celiac disease among patients under 10 years of age. Atypical symptoms become relevant in patients older than 10 years. Antiendomysial and antitransglutaminase antibody measurement should be incorporated for routine screening and follow up of celiac disease in public hospitals. To improve food labeling about their gluten content is needed.