More money, more problems, as the saying goes. Could celiac disease be one of those problems?
A large study in the United Kingdom (UK) revealed that celiac disease was diagnosed more often in groups with higher socioeconomic status. It also added to the findings of other studies that have shown that the number of total cases was on the rise.
"Children living in less socioeconomically deprived areas in the UK are more likely to be diagnosed with CD," the authors of this study wrote. "Increased implementation of diagnostic guidelines could result in better case identification in more-deprived areas."
Celiac disease is an autoimmune disorder that affects the digestive system. In patients with the disease, ingestion of gluten (a protein found in wheat, rye and barley) causes damage to the small intestine. When the intestinal wall is damaged, the body cannot absorb nutrients from food. Over time, this can lead to a number of health problems, such as malnutrition, osteoporosis and anemia.
Patients diagnosed with celiac disease must maintain a gluten-free diet to avoid intestinal damage. This means products that contain wheat or wheat flour (most breads, cakes, cereals, pizzas and pastas) are off-limits. There are alternative versions of many foods that can be made with rice or tapioca flour instead.
Dr. Fabiana Zingone, of the Division of Epidemiology and Public Health at the University of Nottingham in the UK, and colleagues studied the medical records of more than 2 million children in the UK for diagnoses of celiac disease. Between 1993 and 2012, 1,247 cases of celiac disease were diagnosed in this group.
More than half of the diagnosed patients were girls. There was also an increase of 75 percent in overall diagnoses between the first five years (1993 to 1997) and the last five years (2008 to 2012). When different age groups were assessed, the incidence of celiac disease remained stable for children aged 2 or younger. However, the number of diagnoses among older children nearly tripled over the 20 years studied.
Dr. Zingone and team found a link between socioeconomic status and the number of cases. Children with a higher socioeconomic status were diagnosed twice as often as than those of the most deprived status. These researchers said they believed this was not due to less prevalence of the disease among the lower socioeconomic groups, but rather less detection of it.
"Another likely possibility is that ascertainment of disease varies, so awareness campaigns for clinicians and the general population may help to implement strategies for case-finding in all children and reduce this inequality,” said study author Dr. Laila J. Tata, in an interview with dailyRx News.
Still, Dr. Zingone and colleagues called for more research on socioeconomic status and celiac disease to further explore this possible link.
This study was published online Jan. 22 in the Archives of Disease in Childhood.
CORE/Coeliac UK and a University of Nottingham/Nottingham University Hospitals NHS Trust Clinical Senior Research Fellowship funded this research. Dr. Zingone and team disclosed no conflicts of interest.