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Article Publish Status: FREE
Abstract Title:

Increased prevalence and mortality in undiagnosed celiac disease.

Abstract Source:

Gastroenterology. 2009 Jul ;137(1):88-93. Epub 2009 Apr 10. PMID: 19362553

Abstract Author(s):

Alberto Rubio-Tapia, Robert A Kyle, Edward L Kaplan, Dwight R Johnson, William Page, Frederick Erdtmann, Tricia L Brantner, W Ray Kim, Tara K Phelps, Brian D Lahr, Alan R Zinsmeister, L Joseph Melton, Joseph A Murray

Article Affiliation:

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA.

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

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.

Study Type : Human Study

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