A1 Refereed original research article in a scientific journal

Incidence of Pediatric Celiac Disease Varies by Region




AuthorsStahl Marisa, Li Qian, Lynch Kristian, Koletzko Sibylle, Mehta Pooja, Gragert Loren, Norris Jill M, Andrén Aronsson Carin, Lindfors Katri, Kurppa Kalle, Ilonen Jorma, Krischer Jeffrey, Alkolkar Beena, Ziegler Anette-G, Toppari Jorma, Rewers Marian J, Agardh Daniel, Hagopian William, Liu Edwin; TEDDY Study Group

PublisherWolters Kluwer

Publication year2023

JournalAmerican Journal of Gastroenterology

Journal name in sourceThe American journal of gastroenterology

Journal acronymAm J Gastroenterol

Volume118

Issue3

First page 539

Last page545

ISSN0002-9270

eISSN1572-0241

DOIhttps://doi.org/10.14309/ajg.0000000000002056

Web address https://journals.lww.com/ajg/Fulltext/2023/03000/Incidence_of_Pediatric_Celiac_Disease_Varies_by.34.aspx


Abstract

INTRODUCTION: 

The Environmental Determinants of Diabetes in the Young study follows an HLA risk selected birth cohort for celiac disease (CD) development using a uniform protocol. Children under investigation come from 6 different regions within Europe and the United States. Our aim was to identify regional differences in CD autoimmunity and CD cumulative incidence for children born between 2004 and 2010.

METHODS: 

Children (n = 6,628) with DQ2.5 and/or DQ8.1 were enrolled prospectively from birth in Georgia, Washington, Colorado, Finland, Germany, and Sweden. Children underwent periodic study screening for tissue transglutaminase antibodies and then CD evaluation per clinical care. Population-specific estimates were calculated by weighting the study-specific cumulative incidence with the population-specific haplogenotype frequencies obtained from large stem cell registries from each site.

RESULTS: 

Individual haplogenotype risks for CD autoimmunity and CD varied by region and affected the cumulative incidence within that region. The CD incidence by age 10 years was highest in Swedish children at 3%. Within the United States, the incidence by age 10 years in Colorado was 2.4%. In the model adjusted for HLA, sex, and family history, Colorado children had a 2.5-fold higher risk of CD compared to Washington. Likewise, Swedish children had a 1.4-fold and 1.8-fold higher risk of CD compared with those in Finland and Germany, respectively.

DISCUSSION: 

There is high regional variability in cumulative incidence of CD, which suggests differential environmental, genetic, and epigenetic influences even within the United States. The overall high incidence warrants a low threshold for screening and further research on region-specific CD triggers.



Last updated on 2025-27-03 at 21:50