MedWire News: Undiagnosed celiac disease is associated with a four-fold increased risk for death, a US study indicates.
The findings also suggest that the prevalence of undiagnosed celiac disease has increased dramatically over the past 50 years.
Joseph Murray (Mayo Clinic, Rochester, Minnesota) and colleagues studied sera collected from 9133 healthy young adults at the Warren Air Force Base in Wyoming between 1948 and 1954 for celiac disease.
Samples were tested for tissue transglutaminase antibodies and, if abnormal, for endomysial antibodies.
Results were compared with 5558 men aged at least 50 years from Olmstead county in Minnesota who had a comparable year of birth to the air force cohort and samples taken between 1995 and 2003.
They were also tested against 7210 younger men from the same county who had samples taken at a similar age to the air force group but between 2006 and 2008.
Overall, 0.2% of the air force cohort had undiagnosed celiac disease, and all-cause mortality in this group was significantly greater than in those testing negative during 45 years of follow-up, with a hazard ratio of 3.9.
Undiagnosed celiac disease was identified in 0.8% of the group with a similar year of birth but sampled later on, and also in 0.9% of the younger group who were sampled this century.
“This study suggests that the prevalence of celiac disease has dramatically increased >4-fold in the United States during the past 50 years, consistent with the finding in a recent study from Europe,” the researchers report in the journal Gastroenterology.
“ Reasons for the increased prevalence of celiac disease over time are unknown,” they add.
“However, because human genetic changes in response to environmental challenges are extremely slow, the most likely explanation may be environmental, such as a change in quantity, quality, or processing of cereal.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009
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