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Incidence of celiac disease rising in US adult population
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Analysis of recent population-based data suggest a significant increase in the frequency of celiac disease among US military personnel and the US adult population in general, according to study results.
Using members of the Army, Navy and Air Force (88.6%) as their study population, researchers conducted a matched, nested case-control study from data compiled from the Defense Medical Surveillance System to describe celiac disease (CD) trends.Participants were on active duty between 1999-2008 (more than 13.7 million person-years). Along with an estimation of incidence and duration of CD-related medical care, researchers used logistic regression to evaluate CD risk following infectious gastroenteritis (IGE) that occurred within 3 years before CD diagnoses.
Investigators determined 455 cases of CD during the study period against a matched control group (n=1,820). CD increased five-fold from 1.3 incidents per 100,000 in 1999 to 6.5 incidents per 100,000 in 2008. Adults aged 34 years and older showed the highest increases (yearly gain of approximately 0.8 cases per 100,000). Rates for women were higher compared with men (7.70/100,000 person-years vs. 2.78/100,000 person-yrs) (P<.001).
Multivariate models illustrated a significant association between IGE and CD (OR=2.06, 95% CI, 1.43-2.97) and on average, CD risk increased based on time after IGE exposure and nonviral etiology. Other statistically significant risk factors included Caucasian race (OR=3.1, P<.001), nonArmy service (OR=1.5; P=.001) and education levels beyond high school (OR=1.3, P=.05).
“Incidence of CD diagnosis in the US military is increasing, particularly among those in the fourth and fifth decades of life,” researchers said. “[It] appears higher than other population-based estimates. We found an association between antecedent infectious gastroenteritis and the risk of CD, and the association appeared strongest in nonviral IGE and contributes to the emerging body of data that warrants further prospective or seroepidemiological studies.”
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