Risk of Celiac Disease in the First- and Second-Degree Relatives of Patients With Celiac Disease: A Systematic Review and Meta-Analysis

Singh, Prashant; Arora, Shubhangi; Lal, Sunil K.; Strand, Tor A.; Makharia, Govind

doi:10.1038/ajg.2015.296

Cited by 124 publications

(108 citation statements)

References 81 publications

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“…Out of five established risk groups, the HLA group 1 (DQ2.5/DQ2.5 and DQ2.5/DQ2.2) showed a four-fold higher risk. The hazard ratio was 4.7 (95% CI: 0.80-27.55) and the p-value was 6 close to the statistical significance (p = 0.08). As shown in table 1, 13 of 26 CD cases belonged to group 1, i.e., 50% of the total cases.…”

Section: Development Riskmentioning

confidence: 84%

“…The importance of gluten, both at the time of introduction into the diet and the amount consumed, as well as its relationship with CD risk have been widely debated during recent years. The recommendations from the Nutrition Committee of ESPGHAN from 2008 are based on observational studies (2,(4)(5)(6). These guidelines suggested that introducing gluten in small amounts, preferably during the breast feeding period, could reduce the risk of CD.…”

Section: Discussionmentioning

confidence: 99%

“…However, these studies have only been performed in adult populations. Therefore, there is no estimate of the prevalence in the at-risk pediatric population (6)(7)(8)(9)(10)(11). Due to the differences in the prevalence of CD, several 3 classical observational studies suggested the need to assess determinant environmental factors with an essential role in the etiopathology of the disease, especially the age of gluten introduction into the diet and the duration of breast feeding (12)(13)(14)(15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

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Ten years of follow-up of the Spanish cohort of the European PreventCD study: the lessons learned

et al. 2018

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Aim: to evaluate the influence of gluten consumption on celiac disease development and to describe its natural history in the Spanish cohort of the European PreventCD study.Methods: prospective multi-center double blind study of 225 children that were followed up from birth. All cases were HLA-DQ2/HLA-DQ8 positive with a 1 st degree relative with celiac disease and were followed up in three centers from Madrid, Reus and Valencia. Gluten intake was determined between four and ten months according to the protocol. Gluten intake was ad libitum between eleven and 36 months and was prospectively quantified by means of dietary records. Clinical visits and specific antibody analysis for celiac disease were performed periodically. Results: twenty-six cases were diagnosed, all had a positive biopsy and serology; 21had gastrointestinal symptoms and five were asymptomatic. In addition, 2,565 food records were analyzed and statistically significant differences (p < 0.001) were found with regard to gluten consumption among the three centers, although not between celiac and non-celiac children (p = 0.025). The HLA-DQ2.5/DQ2.5 and DQ2.5/DQ2.2 genotypes had a relative risk of 4.7 (95% CI: 0.80-27.55; p = 0.08), which was higher than for the rest of genotypes. Female gender also had a relative risk that was five times higher than that for males.Conclusions: the amount of gluten intake between eleven and 36 months or the duration of breast feeding were not risk factors for the development of CD in the Spanish population. The HLA genotype and gender were the most relevant associated factors. In this at-risk group, the disease presented before two years of age in the majority of the cases with a weak clinical expression.

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Section: Development Riskmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ten years of follow-up of the Spanish cohort of the European PreventCD study: the lessons learned

et al. 2018

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“…Eine serologische Testung auf Zöliakie ist für Angehörige ersten Grades von Zöliakiepatienten indiziert, da diese ein bis zu 7,5 %iges Erkrankungsrisiko haben [28]. Ferner sollten Patienten mit assoziierten autoimmunen oder genetischen Grunderkrankungen (.…”

Section: Screening Von Risikopatientenunclassified

Zöliakie

Schuppan

2016

Bundesgesundheitsbl

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Celiac disease is induced by the consumption of gluten containing cereals (wheat, spelt, barley, rye). With a prevalence of ~ 1 %, it is the most common non-infectious chronic inflammatory intestinal disease worldwide. It manifests in all age groups, either classically with abdominal pain, diarrhoea and growth failure or weight loss, more commonly with indirect consequences of malabsorption, such as anaemia and osteoporosis, or with associated autoimmune diseases like type 1 diabetes, autoimmune thyroiditis or dermatitis herpetiformis. The pathogenesis of celiac disease is well explored. Gluten, the cereal storage protein, is not completely digested and reaches the intestinal mucosa where it activates inflammatory T cells, which cause atrophy of the resorptive villi. This T‑cell activation requires a genetic predisposition (the molecules HLA-DQ2 or -DQ8 on antigen-presenting immune cells). Moreover, the enzyme tissue transglutaminase (TG2) which is released in the mucosa increases the immunogenicity of the gluten peptides by a deamidation reaction. The test for serum antibodies to the autoantigen TG2 is one of the best diagnostic markers in medicine, which in combination with endoscopically obtained biopsies, secures the diagnosis of celiac disease. Despite these tools celiac disease is severely underdiagnosed, with 80-90 % of those affected being undetected. The untreated condition can lead to grave complications. These include the consequences of malabsorption, cancers (especially intestinal T‑cell lymphoma), and likely also the promotion of autoimmune diseases. The therapy of celiac disease, a strict gluten-free diet, is difficult to maintain and not always effective. Alternative, supporting pharmacological therapies are urgently needed and are currently in development.

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“…Coeliac disease occurs in genetically predisposed individuals; therefore, first‐degree relatives (FDRs) are the main risk group for this disease, with an overall prevalence of 7.5% . The screening method in this risk group is based on serological procedures, followed by duodenal biopsy, in cases with positive serology.…”

Section: Introductionmentioning

confidence: 99%

Coeliac disease and gastrointestinal symptom screening in adult first‐degree relatives

Vaquero

Rodríguez-Martín

Álvarez-Cuenllas

et al. 2017

J of Gastro and Hepatol

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Risk of Celiac Disease in the First- and Second-Degree Relatives of Patients With Celiac Disease: A Systematic Review and Meta-Analysis

Abstract: Pooled prevalence of CD among FDRs is 7.5% and varies considerably with their relationship with the index patient. The risk of CD in FDRs also varies according to gender and geographical location.

Cited by 124 publications

References 81 publications

Ten years of follow-up of the Spanish cohort of the European PreventCD study: the lessons learned

Ten years of follow-up of the Spanish cohort of the European PreventCD study: the lessons learned

Zöliakie

Coeliac disease and gastrointestinal symptom screening in adult first‐degree relatives

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