Celiac Disease: More Prominent in Women, Underdiagnosed in Kids, and other Epidemiologic Trends. 4 Studies At-a-Glance based on presentatations at Digestive Diseases Week 2018, June 2-5, 2018, Washington, DC.
From self-reported wheat intolerance to non-celiac gluten sensitivity diagnosis: an Italian community-based study.
Non-Celiac Gluten Sensitivity: Just How Prevalent? Non-celiac gluten sensitivity (NCGS) was defined as a clinical condition in 2011 and is increasing worldwide with a prevalence of 0.5% to 13%.
Italian Community Study: Low Prevalence of NCGS. Conclusions: This study confirmed low prevalence of NCGS although it may be even lower in general population and there was an overlap between functional GI syndromes and food intolerance; it remains unclear how IBS is distinct from self-reported wheat insensitivity.
Gender-based differences in screened populations in celiac disease: a systematic review and meta-analysis.
Are Women More Likely to go Undiagnosed for CD? Authors aimed to determine if the gender differences in diagnosed celiac diseas extends to undiagnosed individuals. This systemic review and meta-analysis looked at 88 studies and nearly 300 000 individuals including those without past diagnosis of CD, who had autoantibody screening and serology and/or biopsy.
Yes: Burden of Undetected CD Higher in Women. Conclusions: Undetected CD is more common in women; children show higher degrees of gender difference in undetected CD; more villous atrophy is seen in women vs men; and the results suggest underlying biological differences.
The rise in incidence of CD has stopped despite increasing application of CD serology testing: a population-based study.
Community Study of Trends in CD Diagnosis. This cross-sectional community substudy assessed patients tested for CD from 1998 to 2015 and evaluated tTGA IgA, tTGA IgG, and histology.
Incidence of CD has Halted Despite Increased Testing. Conclusions: Yield of CD testing in capturing undiagnosed CD decreased, suggesting some indications for CD testing should be re-considered; however, it is still important for PCPs to test for CD, especially in children and those with positive family history.
Screening the general pediatric population for celiac disease: autoimmunity screening for kids (The ASK Study).
ASK Study: Celiac and T1D Screening in Kids. The initial symptoms screened for T1D included islet autoantibodies and for CD included tTGA-IgA and RBA for IgA, IgG, and IgM. A positive screen was followed by a confirmatory blood draw and a detailed symptoms questionnaire.
Undiagnosed CD in Kids Prevalence Relatively High. Conclusions: Relatively high prevalence of undiagnosed CD in general pediatric population, presence of symptoms is not a good indicator of CD. Current study is ongoing and will give a better picture of natural history of undiagnosed CD.
Take Home Points:
Italian community study confirmed low rates of NCGS.
Systematic review and meta-analysis found women are more likely to go undetected for CD vs men.
Community study in Minnesota found the incidence of CD has halted despite increased testing, but rates of testing in children are still relatively low.
ASK, a mass screening program for T1D and CD in Denver, found a relatively high prevalence of undiagnosed CD in children.