Prevalence of occult celiac disease in females with iron deficiency in the United States: an NHANES analysis

• Published in: Journal of community hospital internal medicine perspectives Vol. 7; no. 6; pp. 347 - 350
• Main Authors: Abdalla, Ahmed, Saifullah, Shaik Mohamed, Osman, Mohamed, Baniya, Ramkaji, Sidahmed, Shima, LaChance, Jenny, Bachuwa, Ghassan
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 01.01.2017; Greater Baltimore Medical Center
• Subjects: Adults; Anemia; Autoimmune diseases; Blood; Celiac disease; Disease control; Disease prevention; Enzymes; Females; Ferritin; Gluten; Hispanic people; Hypersensitivity; Immunoglobulin A; Iron; Iron deficiency; Medical laboratories; Nutrient deficiency; Nutrition research; Patients; Population; Regression analysis; Small intestine; Transglutaminase 2; United Kingdom > UK; England; United States > US; Celiac disease; iron deficiency
• ISSN: 2000-9666; 2000-9666
• DOI: 10.1080/20009666.2017.1396169

Aim: The prevalence of celiac disease (CD) in patients with iron deficiency (ID) is estimated at 0-6% in European countries. The prevalence of celiac disease in patients with iron deficiency in the USA is unknown. Given the treatable nature of gluten hypersensitivity, estimating the prevalence of CD in patients with ID can help to determine the need to screen these patients for occult CD. Methods: Data were obtained from the NHANES database, a nationally representative health survey conducted from 2009 to 2010. We included 2,105 females aged 6 years or older. Iron deficiency was defined as serum ferritin level <20 ng/ml and considered positive for celiac disease when subjects were tested positive for both immunoglobulin A (IgA) tissue transglutaminase antibody and IgA endomysial antibody. Subjects were divided between two groups (ID and non-ID). The association of CD and ID, which was the primary outcome, was obtained after adjusting for other covariates using logistic regression. Results: Among the sample of 2,105 subjects, 569 had ID and 1536 did not have ID. Five people were identified as having CD among the ID group, as were two people in the non-ID group. After adjusting for selected covariates, the prevalence of CD was higher in female subjects with ID with OR of 12.5 (95% CI 1.74-90). Conclusions: The overall prevalence of celiac disease in the USA' female population is low, however, the prevalence is higher in subjects with iron deficiency. Further prospective studies are needed to validate our findings.