The prevalence of celiac disease in the United States

Am J Gastroenterol. 2012 Oct;107(10):1538-44; quiz 1537, 1545. doi: 10.1038/ajg.2012.219. Epub 2012 Jul 31.

Abstract

Objectives: The prevalence of celiac disease (CD) in the United States is unknown. We sought to estimate CD prevalence nationwide by using a nationally representative sample.

Methods: This study included 7,798 persons aged 6 years or older who participated in the National Health and Nutrition Examination Survey 2009-2010. Serum samples from all participants were tested for immunoglobulin A (IgA) tissue transglutaminase antibodies and, if findings were abnormal, also for IgA endomysial antibodies. Information about prior diagnosis of CD and use of a gluten-free diet (GFD) was obtained by direct interview. CD was defined as having either double-positive serology (serologically diagnosed CD) or a reported diagnosis of CD by a doctor or other health-care professional and being on a GFD (reported clinical diagnosis of CD).

Results: CD was found in 35 participants, 29 of whom were unaware of their diagnosis. Median age was 45 years (interquartile range, 23-66 years); 20 were women and 29 were non-Hispanic white. The prevalence of CD in the United States was 0.71% (95% confidence interval (CI), 0.58-0.86%), with 1.01% (95% CI, 0.78-1.31%) among non-Hispanic whites. In all, 55 participants reported following a GFD, which corresponded to a prevalence of 0.63% (95% CI, 0.36-1.07%).

Conclusions: The prevalence of CD in the United States was 0.71% (1 in 141), similar to that found in several European countries. However, most cases were undiagnosed. CD was rare among minority groups but affected 1% of non-Hispanic whites. Most persons who were following a GFD did not have a diagnosis of CD.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • African Americans / statistics & numerical data
  • Aged
  • Autoantibodies / blood*
  • Biomarkers / blood
  • Celiac Disease / diagnosis*
  • Celiac Disease / diet therapy
  • Celiac Disease / epidemiology*
  • Celiac Disease / ethnology
  • Celiac Disease / immunology
  • Diet, Gluten-Free / statistics & numerical data*
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Humans
  • Immunoglobulin A / blood
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Prevalence
  • Transglutaminases / immunology
  • United States / epidemiology

Substances

  • Autoantibodies
  • Biomarkers
  • Immunoglobulin A
  • Transglutaminases