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Digestive Diseases and Sciences

, Volume 60, Issue 6, pp 1738–1742 | Cite as

Racial Differences in the Prevalence of Celiac Disease in the US Population: National Health and Nutrition Examination Survey (NHANES) 2009–2012

  • Houssam E. Mardini
  • Philip Westgate
  • Alla Y. Grigorian
Original Article

Abstract

Aim

To provide an estimate of the prevalence of celiac disease by race/ethnic origin in large sample of US population.

Methods

Data from the 2009–2010 and 2011–2012 NHANES were combined and analyzed. The NHANES is a nationally representative survey with oversampling of certain minorities. Sample-based frequencies were reported and weighted frequencies were used to estimate prevalence.

Results

A total of 14,701 participants were checked for tissue transglutaminase (tTG) and endomysial (EMA) IgA antibodies. Seventy-four participants had positive tTG and/or EMA corresponding to prevalence of 0.79 % (95 % CI 0.54–1.04 %). Non-Hispanic white were more likely to be positive for both compared with other races (72.0 vs 31.7 %; p = 0.010) and less likely to be weakly positive for tTG but positive for EMA (3.6 vs 26.4 %; p = 0.03). The prevalence of positive serology according to race was as follows: 1.08 % (95 % CI 0.70–1.45 %) in non-Hispanic white, 0.23 % (95 % CI 0.03–0.43 %) in Mexican, 0.22 % (95 % CI 0.01–0.44 %) in non-Hispanic black, 0.38 % (95 % CI 0.00–0.89 %) in “other Hispanic,” and 0.15 % (95 % CI 0.00–0.34 %) in other races including multiracial and undeterminable in non-Hispanic Asian due to the presence of only one positive EMA test. 0.9 % of the NHANES sample participants followed gluten-free diet. Of this group of participants, 85 % were never diagnosed with celiac disease and 99 % of them had negative celiac disease serology.

Conclusions

Potentially 0.79 % of the general US population demonstrate serologic evidence of celiac disease autoimmunity. The prevalence is 4–8 times higher among non-Hispanic white compared with other races. Close to 1 % of the population is electively following gluten-free diet despite having little evidence of the disease.

Keywords

Celiac disease autoimmunity Racial differences Gluten 

Notes

Conflict of interest

The authors report no conflict of interest or financial support relevant to this work. All authors approved the final version of the manuscript.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Houssam E. Mardini
    • 1
  • Philip Westgate
    • 2
  • Alla Y. Grigorian
    • 3
  1. 1.Lexington VA Medical CenterUniversity of Kentucky College of MedicineLexingtonUSA
  2. 2.University of Kentucky College of Public HealthLexingtonUSA
  3. 3.Miller School of MedicineUniversity of MiamiMiamiUSA

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