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Meta-Analysis
. 2018 Jun;16(6):823-836.e2.
doi: 10.1016/j.cgh.2017.06.037. Epub 2018 Mar 16.

Global Prevalence of Celiac Disease: Systematic Review and Meta-analysis

Prashant Singh  1 , Ananya Arora  2 , Tor A Strand  3 , Daniel A Leffler  4 , Carlo Catassi  5 , Peter H Green  6 , Ciaran P Kelly  1 , Vineet Ahuja  7 , Govind K Makharia  8
Affiliations
Meta-Analysis

Global Prevalence of Celiac Disease: Systematic Review and Meta-analysis

Prashant Singh et al. Clin Gastroenterol Hepatol. 2018 Jun.

Abstract

Background & aims: Celiac disease is a major public health problem worldwide. Although initially it was reported from countries with predominant Caucasian populations, it now has been reported from other parts of the world. The exact global prevalence of celiac disease is not known. We conducted a systematic review and meta-analysis to estimate the global prevalence of celiac disease.

Methods: We searched Medline, PubMed, and EMBASE for the keywords celiac disease, celiac, celiac disease, tissue transglutaminase antibody, anti-endomysium antibody, endomysial antibody, and prevalence for studies published from January 1991 through March 2016. Each article was cross-referenced with the words Asia, Europe, Africa, South America, North America, and Australia. The diagnosis of celiac disease was based on European Society of Pediatric Gastroenterology, Hepatology, and Nutrition guidelines. Of 3843 articles, 96 articles were included in the final analysis.

Results: The pooled global prevalence of celiac disease was 1.4% (95% confidence interval, 1.1%-1.7%) in 275,818 individuals, based on positive results from tests for anti-tissue transglutaminase and/or anti-endomysial antibodies (called seroprevalence). The pooled global prevalence of biopsy-confirmed celiac disease was 0.7% (95% confidence interval, 0.5%-0.9%) in 138,792 individuals. The prevalence values for celiac disease were 0.4% in South America, 0.5% in Africa and North America, 0.6% in Asia, and 0.8% in Europe and Oceania; the prevalence was higher in female vs male individuals (0.6% vs 0.4%; P < .001). The prevalence of celiac disease was significantly greater in children than adults (0.9% vs 0.5%; P < .001).

Conclusions: In a systematic review and meta-analysis, we found celiac disease to be reported worldwide. The prevalence of celiac disease based on serologic test results is 1.4% and based on biopsy results is 0.7%. The prevalence of celiac disease varies with sex, age, and location. There is a need for population-based prevalence studies in many countries.

Keywords: Autoimmune Disorder; Diet; Epidemiology; Gluten.

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Comment in

  • Screening for Celiac Disease in Canada.
    Freeman HJ. Freeman HJ. Clin Gastroenterol Hepatol. 2018 Dec;16(12):2002-2003. doi: 10.1016/j.cgh.2018.07.033. Clin Gastroenterol Hepatol. 2018. PMID: 30454935 No abstract available.
  • Reply.
    Singh P, Makharia GK. Singh P, et al. Clin Gastroenterol Hepatol. 2018 Dec;16(12):2003. doi: 10.1016/j.cgh.2018.08.030. Clin Gastroenterol Hepatol. 2018. PMID: 30454937 No abstract available.