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. 2009 Jul;137(1):88-93.
doi: 10.1053/j.gastro.2009.03.059. Epub 2009 Apr 10.

Increased prevalence and mortality in undiagnosed celiac disease

Alberto Rubio-Tapia  1 , Robert A Kyle, Edward L Kaplan, Dwight R Johnson, William Page, Frederick Erdtmann, Tricia L Brantner, W Ray Kim, Tara K Phelps, Brian D Lahr, Alan R Zinsmeister, L Joseph Melton 3rd, Joseph A Murray
Affiliations

Increased prevalence and mortality in undiagnosed celiac disease

Alberto Rubio-Tapia et al. Gastroenterology. 2009 Jul.

Abstract

Background & aims: The historical prevalence and long-term outcome of undiagnosed celiac disease (CD) are unknown. We investigated the long-term outcome of undiagnosed CD and whether the prevalence of undiagnosed CD has changed during the past 50 years.

Methods: This study included 9133 healthy young adults at Warren Air Force Base (sera were collected between 1948 and 1954) and 12,768 gender-matched subjects from 2 recent cohorts from Olmsted County, Minnesota, with either similar years of birth (n = 5558) or age at sampling (n = 7210) to that of the Air Force cohort. Sera were tested for tissue transglutaminase and, if abnormal, for endomysial antibodies. Survival was measured during a follow-up period of 45 years in the Air Force cohort. The prevalence of undiagnosed CD between the Air Force cohort and recent cohorts was compared.

Results: Of 9133 persons from the Air Force cohort, 14 (0.2%) had undiagnosed CD. In this cohort, during 45 years of follow-up, all-cause mortality was greater in persons with undiagnosed CD than among those who were seronegative (hazard ratio = 3.9; 95% confidence interval, 2.0-7.5; P < .001). Undiagnosed CD was found in 68 (0.9%) persons with similar age at sampling and 46 (0.8%) persons with similar years of birth. The rate of undiagnosed CD was 4.5-fold and 4-fold greater in the recent cohorts, respectively, than in the Air Force cohort (both P < or = .0001).

Conclusions: During 45 years of follow-up, undiagnosed CD was associated with a nearly 4-fold increased risk of death. The prevalence of undiagnosed CD seems to have increased dramatically in the United States during the past 50 years.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure
Figure
Survival during 45 years of follow-up in 14 subjects with undiagnosed celiac disease (CD) and 9,076 seronegative persons in the Warren Air Force Base cohort.
See this image and copyright information in PMC

References

    1. Green PH, Cellier C. Celiac disease. N Engl J Med. 2007 Oct 25;357(17):1731–43. - PubMed
    1. Rostom A, Murray JA, Kagnoff MF. American Gastroenterological Association (AGA) Institute technical review on the diagnosis and management of celiac disease. Gastroenterology. 2006 Dec;131(6):1981–2002. - PubMed
    1. Talley NJ, Valdovinos M, Petterson TM, Carpenter HA, Melton LJ., 3rd Epidemiology of celiac sprue: a community-based study. Am J Gastroenterol. 1994 Jun;89(6):843–6. - PubMed
    1. Rossi TM, Albini CH, Kumar V. Incidence of celiac disease identified by the presence of serum endomysial antibodies in children with chronic diarrhea, short stature, or insulin-dependent diabetes mellitus. J Pediatr. 1993 Aug;123(2):262–4. - PubMed
    1. Catassi C. The world map of celiac disease. Acta Gastroenterol Latinoam. 2005;35(1):37–55. - PubMed

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