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 ≤ .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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 88-93 |
| Number of pages | 6 |
| Journal | Gastroenterology |
| Volume | 137 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jul 2009 |
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ASJC Scopus subject areas
- Gastroenterology
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Increased Prevalence and Mortality in Undiagnosed Celiac Disease. / Rubio-Tapia, Alberto; Kyle, Robert A.; Kaplan, Edward L.; Johnson, Dwight R.; Page, William; Erdtmann, Frederick; Brantner, Tricia L.; Kim, W. Ray; Phelps, Tara K.; Lahr, Brian D.; Zinsmeister, Alan R.; Melton, L. Joseph; Murray, Joseph A.
In: Gastroenterology, Vol. 137, No. 1, 07.2009, p. 88-93.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Increased Prevalence and Mortality in Undiagnosed Celiac Disease
AU - Rubio-Tapia, Alberto
AU - Kyle, Robert A.
AU - Kaplan, Edward L.
AU - Johnson, Dwight R.
AU - Page, William
AU - Erdtmann, Frederick
AU - Brantner, Tricia L.
AU - Kim, W. Ray
AU - Phelps, Tara K.
AU - Lahr, Brian D.
AU - Zinsmeister, Alan R.
AU - Melton, L. Joseph
AU - Murray, Joseph A
PY - 2009/7
Y1 - 2009/7
N2 - 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 ≤ .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.
AB - 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 ≤ .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.
UR - http://www.scopus.com/inward/record.url?scp=67649200339&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67649200339&partnerID=8YFLogxK
U2 - 10.1053/j.gastro.2009.03.059
DO - 10.1053/j.gastro.2009.03.059
M3 - Article
C2 - 19362553
AN - SCOPUS:67649200339
VL - 137
SP - 88
EP - 93
JO - Gastroenterology
JF - Gastroenterology
SN - 0016-5085
IS - 1
ER -