title: The prevalence of coeliac disease is significantly higher in children compared with adults.
abstract: BACKGROUND
  Some limited studies of coeliac disease have shown higher frequency of coeliac disease in infancy and adolescence than in adulthood. This finding has remained unnoticed and not adequately demonstrated.
  
  
  OBJECTIVE
  To assess whether there are age and gender differences in coeliac disease prevalence.
  
  
  METHODS
  A total of 4230 subjects were included consecutively (1 to ≥80 years old) reproducing the reference population by age and gender. Sample size was calculated assuming a population-based coeliac disease prevalence of 1:250. After an interim analysis, the paediatric sample was expanded (2010 children) due to high prevalence in this group. Anti-transglutaminase and antiendomysial antibodies were determined and duodenal biopsy was performed if positive. Log-linear models were fitted to coeliac disease prevalence by age allowing calculation of percentage change of prevalence. Differences between groups were compared using Chi-squared test.
  
  
  RESULTS
  Twenty-one subjects had coeliac disease (male/female 1:2.5). Coeliac disease prevalence in the total population was 1:204. Coeliac disease prevalence was higher in children (1:71) than in adults (1:357) (P = 0.00005). A significant decrease of prevalence in older generations was observed [change of prevalence by age of -5% (95% CI: -7.58 to -2.42%)]. In the paediatric expanded group (1-14 years), a decrease of coeliac disease prevalence was also observed [prevalence change: -17% (95% CI: -25.02 to -6.10)].
  
  
  CONCLUSIONS
  The prevalence of coeliac disease in childhood was five times higher than in adults. Whether this difference is due to environmental factors influencing infancy, or latency of coeliac disease in adulthood, remains to be demonstrated in prospective longitudinal studies.
authors.affiliation: Department of Gastroenterology, Hospital Universitari Mútua de Terrassa, Universitat de Barcelona, Catalonia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Mariné
authors.forename: C
authors.initials: C
authors.lastname: Farre
authors.forename: M
authors.initials: M
authors.lastname: Alsina
authors.forename: P
authors.initials: P
authors.lastname: Vilar
authors.forename: M
authors.initials: M
authors.lastname: Cortijo
authors.forename: A
authors.initials: A
authors.lastname: Salas
authors.forename: F
authors.initials: F
authors.lastname: Fernández-Bañares
authors.forename: M
authors.initials: M
authors.lastname: Rosinach
authors.forename: R
authors.initials: R
authors.lastname: Santaolalla
authors.forename: C
authors.initials: C
authors.lastname: Loras
authors.forename: T
authors.initials: T
authors.lastname: Marquès
authors.forename: V
authors.initials: V
authors.lastname: Cusí
authors.forename: M I
authors.initials: MI
authors.lastname: Hernández
authors.forename: A
authors.initials: A
authors.lastname: Carrasco
authors.forename: J
authors.initials: J
authors.lastname: Ribes
authors.forename: J M
authors.initials: JM
authors.lastname: Viver
authors.forename: M
authors.initials: M
authors.lastname: Esteve
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002446:Celiac Disease / Q000453:epidemiology* / Q000235:genetics / Q000503:physiopathology; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult