Prevalence of coeliac disease in Northwest China: heterogeneity across Northern Silk road ethnic populations

Abstract

Background: Epidemiological data of coeliac disease are lacking from the central Asian region. Aims: To verify the occurrence of coeliac disease amongst four major ethnic groups of Xinjiang Uyghur Autonomus Region, China. Methods: 2277 in-patients with gastrointestinal symptoms (1391 Han, 608 Uyghur, 146 Kazakh and 132 Hui; mean age: 54 ± 12.8 years) were included. Total IgA, antideamidated gliadin peptide (DGP)-IgG, and anti-tissue transglutaminase (anti-tTG)-IgA were analysed. All antibody-positive subjects were further tested for endomysial (EMA) antibodies and were HLA genotyped. All subjects with antibody positivity were asked to undergo intestinal biopsy. In addition, a subset of antibody-negative subjects were tested for HLA-DQA1and DQB1.Results: Among the 2277 subjects, 29 subjects were defined as coeliac disease autoimmune (positive results for anti-tTG IgA and EMA-IgA) (1.27%; 95% confidence interval, 0.81%-1.73%), eight of them underwent biopsy and all showed coeliac disease histology (0.35%; 95% Cl, 0.11%-0.59%). The frequency of coeliac disease autoimmunity was lowest among the Han (0.79%), followed by the Uyghur (1.81%), the Kazakh (2.05%) and the Hui (3.03%). The frequency of the HLA-DQ2 and/or DQ8 haplotype was highest in the Uyghur (52.1%), followed by the Hui (44.4%), the Kazakh (40.0%) and the Han (39.4%). Besides, a three times higher frequency of coeliac disease autoimmunity was found among rural living subjects with significantly higher wheat consumption compared to urban living subjects (3.16% vs 0.97%, P < 0.01). Conclusions:In Xinjiang, coeliac disease does occur, especially in the rural area. The HLA haplotype and environment play key roles in the development of coeliac disease. | 1117ZHOU et al.

Opportunities and challenges in the management of celiac disease in Asia

“…14 In another recent study including 2277 patients with gastrointestinal symptoms in four major ethnic groups of Xinjiang Uyghur Autonomous Region, China (1391 Han, 608 Uyghur,146 Kazakh, and 132 Hui), the seroprevalence and prevalence of biopsy-confirmed CeD was found to be 1.27% (95% CI, 0.81-1.73%) and 0.35% (95% CI, 0.11-0.59%), respectively. 15 The frequency of the HLA-DQ2 and/or DQ8 haplotype was the highest in the Uyghur (52.1%), followed by the Hui (44.4%), the Kazakh (40.0%), and the Han (39.4%). CeD was found to be three times more common in rural parts with significantly higher wheat consumption compared to urban living subjects.…”

“…A population‐based prevalence study including 19 778 healthy asymptomatic young Chinese individuals from 27 geographic regions suggested a prevalence of CeD of 0.76% in Shandong province, where wheat is the staple diet 14 . In another recent study including 2277 patients with gastrointestinal symptoms in four major ethnic groups of Xinjiang Uyghur Autonomous Region, China (1391 Han, 608 Uyghur,146 Kazakh, and 132 Hui), the seroprevalence and prevalence of biopsy‐confirmed CeD was found to be 1.27% (95% CI, 0.81–1.73%) and 0.35% (95% CI, 0.11–0.59%), respectively 15 . The frequency of the HLA‐DQ2 and/or DQ8 haplotype was the highest in the Uyghur (52.1%), followed by the Hui (44.4%), the Kazakh (40.0%), and the Han (39.4%).…”

Emergence of Celiac disease and Gluten-related disorders in Asia

“… 29 In another recent study including 2277 in-patients with gastrointestinal symptoms in 4 major ethnic groups of Xinjiang Uyghur Autonomous Region, China (1391 Han, 608 Uyghur, 146 Kazakh, and 132 Hui), the seroprevalence and prevalence of biopsy-confirmed CeD was found to be 1.27% (95% CI, 0.81-1.73%) and 0.35% (95% Cl, 0.11-0.59%), respectively. 38 The frequency of the HLA-DQ2 and/or DQ8 haplotype ranged from 40.0-52.1% in that region. The rural parts of China, where wheat consumption was higher than the urban part, had 3 times higher prevalence of CeD (3.16% vs 0.97%, P < 0.01).…”

Distribution of HLA‐DQA1, ‐DQB1 and ‐DRB1 genes and haplotypes in Han, Uyghur, Kazakh and Hui populations inhabiting Xinjiang Uyghur Autonomous Region, China

“…For HLA-DQA1 and HLA-DQB1 gene amplification, the polymorphisms of two genes were mainly located in the exon 2 as the HLA-DRB1 gene. Therefore, one 5' primer and one 3' primer which can identify the exon 2 of DQA1 or DQB1 gene were produced (Zhou et al, 2020) Raw data can be accessed at Allele Frequencies Net Database (accession numbers: AFND3732(Hui), AFND3733(Kazakh), AFND3734(Uyghur), AFND3735(Han)) (Santos et al, 2016).…”