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J Pediatr. 2003 Sep;143(3):308-14.

A prospective study of the incidence of childhood celiac disease.

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1
Department of Pediatrics, Barbara Davis Center for Childhood Diabetes, University of Colorado, Denver, USA.

Abstract

OBJECTIVES:

To estimate the frequency of celiac disease (CD) in children in the general population of Denver, Colorado.

STUDY DESIGN:

From 22,346 newborns characterized as expressing 0, 1, or 2 HLA-DR3(DQB1*0201) alleles, 987 were selected for a prospective stratified cohort study. Participants were followed for as long as 7 years with serial testing for serum IgA anti-transglutaminase antibodies and for evidence of CD (intestinal mucosal changes or persistent seropositivity).

RESULTS:

Of 40 children with at least one positive serologic test, 19 had evidence of CD (10 by biopsy, 9 by persistent seropositivity). Those expressing 0, 1, or 2 HLA-DR3 alleles had, respectively, 0.3% (95% CI, 0.0-2.7), 3.4% (3.0-11.7), and 3.2% (1.0-11.0) risk for evidence of CD by age 5 years. The adjusted risk estimate for evidence of CD by age 5 years for the Denver general population was 0.9% (0.4-2.0), or 1 in 104 (1:49-221). After adjusting for number of HLA-DR3 alleles expressed, risk was higher in females: RR=3.34 (1.00-10.9, P=.048). Evidence of CD was not observed before age 2.6 years.

CONCLUSIONS:

Celiac disease may affect 0.9% of Denver children by 5 years of age. Children positive for the HLA-DR3 allele and females appear to be at increased risk.

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PMID:
14517510
[Indexed for MEDLINE]

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