The prevalence of celiac disease in Europe: results of a centralized, international mass screening project.
BACKGROUND
Although the prevalence of celiac disease (CD) has been extensively investigated in recent years, an accurate estimate of CD frequency in the European population is still lacking. The aims of this study were: 1) to establish accurately the prevalence of CD in a large sample of the European population (Finland, Germany, Italy, and UK), including both children and adults; and 2) to investigate whether the prevalence of CD significantly varies between different areas of the European continent.


METHODS
Samples were drawn from the four populations. All 29,212 participants were tested for CD by tissue transglutaminase (tTG) antibody test. Positive and border-line findings were further tested for serum endomysial antibodies (EMA). All serological determinations were centrally performed. Small-bowel biopsies were recommended to autoantibody-positive individuals. Previously diagnosed cases were identified.


RESULTS
The overall CD prevalence (previously diagnosed plus anti-tTG and EMA positives) was 1.0% (95% CI 0.9-1.1). In subjects aged 30-64 years CD prevalence was 2.4% in Finland (2.0-2.8), 0.3% in Germany (0.1-0.4), and 0.7% in Italy (0.4-1.0). Sixty-eight percent of antibody-positive individuals showed small-bowel mucosal changes typical for CD (Marsh II/III lesion).


CONCLUSIONS
CD is common in Europe. CD prevalence shows large unexplained differences in adult age across different European countries.
Paediatric Research Centre, University of Tampere and Department of Paediatrics, Tampere University Hospital, Tampere, Finland.
Kirsi
K
Mustalahti
Carlo
C
Catassi
Antti
A
Reunanen
Elisabetta
E
Fabiani
Margit
M
Heier
Stan
S
McMillan
Liam
L
Murray
Marie-Helene
MH
Metzger
Maurizio
M
Gasparin
Enzo
E
Bravi
Markku
M
Mäki
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000097:blood; D001706:Biopsy; D002446:Celiac Disease / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D004797:Enzyme-Linked Immunosorbent Assay; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D011503:Transglutaminases / Q000276:immunology; D055815:Young Adult
D000906:Antibodies; D011503:Transglutaminases