Incidence of Celiac Disease Is Increasing Over Time: A Systematic Review and Meta-analysis

To conduct a systematic review and meta-analysis that defines the worldwide incidence of celiac disease (CD) and examines temporal trends. MEDLINE and EMBASE were searched for population-based studies reporting the incidence of CD in the overall population, children, or adults. No limits were placed...

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Bibliographic Details
Published in:The American journal of gastroenterology Vol. 115; no. 4; pp. 507 - 525
Main Authors: King, James A., Jeong, Jocelyn, Underwood, Fox E., Quan, Joshua, Panaccione, Nicola, Windsor, Joseph W., Coward, Stephanie, deBruyn, Jennifer, Ronksley, Paul E., Shaheen, Abdel-Aziz, Quan, Hude, Godley, Jenny, Veldhuyzen van Zanten, Sander, Lebwohl, Benjamin, Ng, Siew C., Ludvigsson, Jonas F., Kaplan, Gilaad G.
Format: Journal Article
Language:English
Published: United States Wolters Kluwer 01.04.2020
Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
Subjects:
21st century
Adults
Age
Celiac disease
Celiac Disease - epidemiology
Children & youth
Confidence intervals
Epidemiology
Females
Gastroenterology
Global Health
Gluten
Humans
Incidence
Meta-analysis
Pediatrics
Population
Risk Factors
Systematic review
Time Factors
Trends
ISSN:0002-9270, 1572-0241, 1572-0241
Online Access:Get full text
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Summary:To conduct a systematic review and meta-analysis that defines the worldwide incidence of celiac disease (CD) and examines temporal trends. MEDLINE and EMBASE were searched for population-based studies reporting the incidence of CD in the overall population, children, or adults. No limits were placed on year or language of publication. Studies solely examining at-risk populations (e.g., patients with type 1 diabetes) were excluded. Random-effects models were performed to meta-analyze sex- and age-specific incidence in the 21st century. Temporal trend analyses assessed the average annual percent change in CD incidence over time. Of 11,189 citations, 86 eligible studies were identified for inclusion, of which 50 were deemed suitable for analyses. In the 21st century, the pooled female incidence of CD was 17.4 (95% confidence interval [CI]: 13.7, 21.1) (I = 99.5%) per 100,000 person-years, compared with 7.8 (95% CI: 6.3, 9.2) (I = 98.6%) in males. Child-specific incidence was 21.3 per 100,000 person-years (95% CI: 15.9, 26.7) (I = 99.7%) compared with 12.9 (95% CI: 7.6, 18.2) (I = 99.9%) in adults. Pooling average annual percent changes showed the incidence of CD to be increasing by 7.5% (95% CI: 5.8, 9.3) (I = 79.6%) per year over the past several decades. Incidence of CD is highest in females and children. Overall, the incidence has been significantly rising in the latter half of the 20th century and into the 21st century throughout the Western world. Population-based studies in Africa, Asia, and Latin America are needed to provide a comprehensive picture of the global incidence of CD.
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ISSN:0002-9270
1572-0241
1572-0241
DOI:10.14309/ajg.0000000000000523