The prevalence of celiac disease in the United States

Alberto Rubio-Tapia, Jonas F. Ludvigsson, Tricia L. Brantner, Joseph A Murray, James E. Everhart

Research output: Contribution to journalArticle

390 Citations (Scopus)

Abstract

Objectives: The prevalence of celiac disease (CD) in the United States is unknown. We sought to estimate CD prevalence nationwide by using a nationally representative sample. Methods: This study included 7,798 persons aged 6 years or older who participated in the National Health and Nutrition Examination Survey 2009-2010. Serum samples from all participants were tested for immunoglobulin A (IgA) tissue transglutaminase antibodies and, if findings were abnormal, also for IgA endomysial antibodies. Information about prior diagnosis of CD and use of a gluten-free diet (GFD) was obtained by direct interview. CD was defined as having either double-positive serology (serologically diagnosed CD) or a reported diagnosis of CD by a doctor or other health-care professional and being on a GFD (reported clinical diagnosis of CD). Results: CD was found in 35 participants, 29 of whom were unaware of their diagnosis. Median age was 45 years (interquartile range, 23-66 years); 20 were women and 29 were non-Hispanic white. The prevalence of CD in the United States was 0.71% (95% confidence interval (CI), 0.58-0.86%), with 1.01% (95% CI, 0.78-1.31%) among non-Hispanic whites. In all, 55 participants reported following a GFD, which corresponded to a prevalence of 0.63% (95% CI, 0.36-1.07%). Conclusions: The prevalence of CD in the United States was 0.71% (1 in 141), similar to that found in several European countries. However, most cases were undiagnosed. CD was rare among minority groups but affected 1% of non-Hispanic whites. Most persons who were following a GFD did not have a diagnosis of CD.

Original languageEnglish (US)
Pages (from-to)1538-1544
Number of pages7
JournalAmerican Journal of Gastroenterology
Volume107
Issue number10
DOIs
StatePublished - Oct 2012

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Celiac Disease
Gluten-Free Diet
Confidence Intervals
Immunoglobulin A
Minority Groups
Antibodies
Nutrition Surveys
Serology
Interviews
Delivery of Health Care

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Rubio-Tapia, A., Ludvigsson, J. F., Brantner, T. L., Murray, J. A., & Everhart, J. E. (2012). The prevalence of celiac disease in the United States. American Journal of Gastroenterology, 107(10), 1538-1544. https://doi.org/10.1038/ajg.2012.219

The prevalence of celiac disease in the United States. / Rubio-Tapia, Alberto; Ludvigsson, Jonas F.; Brantner, Tricia L.; Murray, Joseph A; Everhart, James E.

In: American Journal of Gastroenterology, Vol. 107, No. 10, 10.2012, p. 1538-1544.

Research output: Contribution to journalArticle

Rubio-Tapia, A, Ludvigsson, JF, Brantner, TL, Murray, JA & Everhart, JE 2012, 'The prevalence of celiac disease in the United States', American Journal of Gastroenterology, vol. 107, no. 10, pp. 1538-1544. https://doi.org/10.1038/ajg.2012.219
Rubio-Tapia, Alberto ; Ludvigsson, Jonas F. ; Brantner, Tricia L. ; Murray, Joseph A ; Everhart, James E. / The prevalence of celiac disease in the United States. In: American Journal of Gastroenterology. 2012 ; Vol. 107, No. 10. pp. 1538-1544.
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AB - Objectives: The prevalence of celiac disease (CD) in the United States is unknown. We sought to estimate CD prevalence nationwide by using a nationally representative sample. Methods: This study included 7,798 persons aged 6 years or older who participated in the National Health and Nutrition Examination Survey 2009-2010. Serum samples from all participants were tested for immunoglobulin A (IgA) tissue transglutaminase antibodies and, if findings were abnormal, also for IgA endomysial antibodies. Information about prior diagnosis of CD and use of a gluten-free diet (GFD) was obtained by direct interview. CD was defined as having either double-positive serology (serologically diagnosed CD) or a reported diagnosis of CD by a doctor or other health-care professional and being on a GFD (reported clinical diagnosis of CD). Results: CD was found in 35 participants, 29 of whom were unaware of their diagnosis. Median age was 45 years (interquartile range, 23-66 years); 20 were women and 29 were non-Hispanic white. The prevalence of CD in the United States was 0.71% (95% confidence interval (CI), 0.58-0.86%), with 1.01% (95% CI, 0.78-1.31%) among non-Hispanic whites. In all, 55 participants reported following a GFD, which corresponded to a prevalence of 0.63% (95% CI, 0.36-1.07%). Conclusions: The prevalence of CD in the United States was 0.71% (1 in 141), similar to that found in several European countries. However, most cases were undiagnosed. CD was rare among minority groups but affected 1% of non-Hispanic whites. Most persons who were following a GFD did not have a diagnosis of CD.

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