Celiac Disease News: Increased Prevalence and Risk of Death in Undiagnosed Celiac Disease

The prevalence of celiac disease has been rising – it’s 4 times more common now than in the 1950’s – and researchers at the Mayo Clinic in Rochester, Minnesota suspect the rise is due to an environmental factor, such as “a change in quantity, quality, or processing of cereal.”

In an article in the July issue of the medical journal Gastroenterology, Dr. Alberto Rubio-Tapia and his colleagues describe a research study in which they analyzed blood samples from three distinct groups:

• Group 1: 9133 healthy young adults who gave blood samples between 1948 and 1954 (these blood samples had been frozen and were still available for analysis)
• Group 2: 5558 present-day elderly residents of Minnesota who were born in the same years as the volunteers in Group 1
• Group 3: 7210 present-day Minnesota residents who are the same age now as Group 1 subjects were when they gave blood samples in 1948-1954.

Using modern tests to detect celiac disease autoantibodies (tissue transglutaminase and endomyseal antibodies), the researchers found that 14, or 0.2%, of the subjects in Group 1 (who had given blood roughly 60 years ago) had undiagnosed celiac disease. When they compared the older samples with the recently obtained samples, they discovered that the rate of undiagnosed celiac disease was 4.0 times higher in modern-day Group 2 (46 elderly people, or 0.8%) and 4.5 times higher in modern-day Group 3 (68 young adults, or 0.9%).

In other words, “the prevalence of celiac disease has dramatically increased more than four-fold in the United States during the past 50 years,” the researchers said. Similar increases have been reported in Europe, they added.

Dr. Rubio-Tapia’s team also compared survival rates in the 1948-1954 study participants with and without undiagnosed celiac disease. During the 45 years after the blood samples were collected, the risk of death was four times higher for people with undiagnosed celiac disease.

In a press release issued by the Mayo Clinic, Dr. Rubio-Tapia’s colleague Dr. Joseph Murray commented, “Some studies have suggested that for every person who has been diagnosed with celiac disease, there are likely 30 more who have it but are not diagnosed. And given the nearly quadrupled mortality risk for silent celiac disease we have shown in our study, getting more patients and health professionals to consider the possibility of celiac disease is important.”

“Moreover,” the research team concludes, “our finding that the prevalence of celiac disease seems to have increased dramatically during the past 50 years suggests that celiac disease is emerging as a substantial public health concern in the United States.”

Special note: On the Mayo Clinic website, you can watch a video of Dr. Murray explaining the research.

_Source:

Rubio-Tapia A et al. Increased prevalence and mortality in undiagnosed celiac disease. Gastroenterology 2009;137:88-93.

Correction (July 6, 2009): The original version of this blog post had the results in groups 2 and 3 reversed. The text as it appears now is correct.

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