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In US, celiac disease diagnosis is most common among patients with Punjabi ancestry

About 1.8 million Americans have celiac disease, an immune-based condition brought on by the consumption of gluten in genetically susceptible patients. Among patients diagnosed with celiac disease by small intestinal biopsy in the U.S., those from the Punjab region of India have the highest rates of disease, according to new research published in Clinical Gastroenterology and Hepatology, the official clinical practice journal of the American Gastroenterological Association.

“While celiac disease was previously thought to be a disease predominantly affecting Caucasian Europeans, it is now recognized as one of the most common hereditary disorders worldwide,” said study author Benjamin Lebwohl, MD, Herbert Irving Assistant Professor of Medicine and Epidemiology at the Celiac Disease Center at Columbia University Medical Center, New York, NY. “Our findings help shed light on the distribution of celiac disease in the U.S. and will aid gastroenterologists in diagnosing their patients.”

This research gives insights into celiac disease found in the U.S. Among patients who underwent testing for celiac disease:

  • Celiac disease was most common among Americans from the Punjab region of India.
  • Celiac disease was significantly less common among U.S. residents of South Indian, East Asian and Hispanic ancestry.
  • The rate of celiac disease among patients of Jewish and Middle Eastern ethnicities was similar to that of other Americans.
  • Men and women had similar rates of celiac disease when tested, no matter their ethnicity.

“While previous studies have suggested that celiac disease may be more common in female patients, based on our findings we recommend that physicians consider celiac disease in men as often as they consider it in women,” added Dr. Lebwohl.

When a patient is having signs of celiac disease, a doctor will do a biopsy in which several small pieces of tissue are sampled from the small intestine for examination with a microscope. The doctor is looking for villous atrophy, or damage to the wall of the small intestine, a finding which most often represents celiac disease.

For this study, Dr. Lebwohl and colleagues looked at more than 400,000 intestinal biopsies from a nationwide database. They identified patients with celiac disease based on the presence of villous atrophy in the small intestine. Using a previously published algorithm based on patient names, the researchers studied celiac disease distribution across these ethnicities: North Indian, South Indian, East Asian, Hispanic, Middle Eastern, Jewish and other Americans.

Ethnic Variations in Duodenal Villous Atrophy Consistent with Celiac Disease in the United States. Anna Krigel, MD, Kevin O. Turner, DO, Govind K. Makharia, MD, DM, DNB, Peter HR. Green, MD, Robert M. Genta, MD, Benjamin Lebwohl, MD, MS. Clinical Gastroenterology and Hepatology. DOI:10.1016/j.cgh.2016.04.032. Published online April 18, 2016.