Prevalence of Celiac Disease Autoimmunity Among Adolescents and Young Adults in China

Juanli Yuan; Chunyan Zhou; Jinyan Gao; Jingjing Li; Fenglian Yu; Jun Lu; Xin Li; Xiaozhong Wang; Ping Tong; Zhihua Wu; Anshu Yang; Yonghong Yao; Sarah Nadif; Heng Shu; Xu Jiang; Yujie Wu; Luud Gilissen; Hongbing Chen

doi:10.1016/j.cgh.2017.04.025

Prevalence of Celiac Disease Autoimmunity Among Adolescents and Young Adults in China

Clin Gastroenterol Hepatol. 2017 Oct;15(10):1572-1579.e1. doi: 10.1016/j.cgh.2017.04.025. Epub 2017 Apr 19.

Authors

Juanli Yuan¹, Chunyan Zhou², Jinyan Gao³, Jingjing Li⁴, Fenglian Yu⁴, Jun Lu², Xin Li², Xiaozhong Wang⁵, Ping Tong⁴, Zhihua Wu⁶, Anshu Yang⁶, Yonghong Yao⁷, Sarah Nadif⁸, Heng Shu⁴, Xu Jiang⁴, Yujie Wu², Luud Gilissen⁸, Hongbing Chen⁹

Affiliations

¹ State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, Jiangxi, China; School of Pharmaceutical Science, Nanchang University, Nanchang, Jiangxi, China.
² State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, Jiangxi, China; School of Food Science and Technology, Nanchang University, Nanchang, Jiangxi, China.
³ School of Food Science and Technology, Nanchang University, Nanchang, Jiangxi, China.
⁴ State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, Jiangxi, China.
⁵ Second Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China.
⁶ State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, Jiangxi, China; Sino-German Joint Research Institute, Nanchang University, Nanchang, Jiangxi, China.
⁷ School Hospital, Nanchang Hangkong University, Nanchang, Jiangxi, China.
⁸ Wageningen University and Research, Plant Sciences Group, Wageningen, The Netherlands.
⁹ State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, Jiangxi, China; Sino-German Joint Research Institute, Nanchang University, Nanchang, Jiangxi, China. Electronic address: chenhongbing@ncu.edu.cn.

PMID: 28433781
DOI: 10.1016/j.cgh.2017.04.025

Abstract

Background & aims: In China, epidemiologic information on celiac disease autoimmunity is scarce and fragmented. We investigated the prevalence of celiac disease autoimmunity in the general Chinese population.

Methods: In a cross-sectional prospective study, 19,778 undiagnosed Chinese adolescents and young adults (age, 16-25 y) were recruited from consecutive new students who underwent routine physical examinations at 2 universities in Jiangxi, China, from September 2010 through October 2013; the students were from 27 geographic regions in China. All subjects were tested for serum IgG, IgG against deamidated gliadin peptides (IgG anti-DGP), and IgA anti-tissue transglutaminase antibodies (IgA anti-tTG). We also analyzed HLA genotypes in subgroups of participants with different results from tests for serum markers of celiac disease.

Results: A total of 434 students (2.19%) tested positive for serum markers for celiac disease (95% confidence interval [CI], 1.99%-2.41%), 0.36% of the students tested positive for anti-tTG IgA (95% CI, 0.28%-0.46%), and 1.88% tested positive for anti-DGP IgG (95% CI, 1.70%-2.09%). The prevalence of celiac disease autoimmunity (positive results in assays for anti-tTG IgA and anti-DGP-IgG) was 0.06% (95% CI, 0.03%-0.10%). Celiac disease autoimmunity was associated with the consumption of wheat and female sex. The prevalence in the Shandong province in north China, where wheat is a staple in the diet, was 0.76% (95% CI, 0.21%-1.95%). The frequencies of the HLA-DQ2/-DQ8 genotypes associated with celiac disease were higher in subjects with celiac disease autoimmunity, based on detection of both serum markers, than in subjects with positive results from a single test (P < .01). All subjects with positive results from both assays carried the HLA-DQ2 genotype.

Conclusions: Approximately 2% of adolescents or young adults in China had positive results from assays for serum markers for celiac disease. The prevalence of celiac disease autoimmunity in the Shandong province in north China, where wheat is a staple in the diet, was 0.76%.

Keywords: Anti–Deamidated Gliadin Peptide; HLA Class Ⅱ Gene; Tissue Transglutaminase Antibody.

MeSH terms

Adolescent
Adult
Autoantibodies / blood
Celiac Disease / epidemiology*
China / epidemiology
Cross-Sectional Studies
Female
GTP-Binding Proteins / immunology
Gliadin / immunology
Humans
Immunoglobulin A / blood
Immunoglobulin G / blood
Male
Prevalence
Prospective Studies
Protein Glutamine gamma Glutamyltransferase 2
Students
Transglutaminases / immunology
Young Adult

Substances

Autoantibodies
Immunoglobulin A
Immunoglobulin G
Gliadin
Protein Glutamine gamma Glutamyltransferase 2
Transglutaminases
GTP-Binding Proteins