Familial risk for celiac disease varies by gender, geographic location
Results from a meta-analysis showed that the pooled prevalence of celiac disease among first-degree relatives of celiac patients was 7.5%, and significantly varied based on relationship, gender and geographic location.
Previous studies report wide variations in prevalence of celiac disease among first-degree relatives of celiac patients, ranging from 1.6% to 38%, the researchers wrote. Furthermore, whether gender, geographical location and relationship to the index patient affect the prevalence of celiac disease among first-degree relatives is unknown.
Researchers conducted a systematic review of relevant literature published from 1991 to July 2014 and included 54 articles in a meta-analysis to calculate the pooled prevalence of celiac disease among 10,252 first- and 642 second-degree relatives and their subgroups.
They found that the pooled prevalence of celiac disease was:
- 7.5% (95% CI, 6.3%-8.8%) among first-degree relatives;
- 2.3% (95% CI, 1.3%-3.8%) among second-degree relatives;
- 8.9% (95% CI, 6.6%-11.2%) among siblings;
- 7.9% (95% CI, 3.1%-12.7%) among offspring;
- 3% (95% CI, 2%-4%) among parents; and
- 15.3% (95% CI, 12.2%-19.9%) among first-degree relatives with two diagnosed siblings.
Prevalence was significantly higher among siblings vs. offspring and parents (both P < .001), among offspring vs. parents (P = .01) and among female vs. male first-degree relatives (8.4% vs. 5.2%; P = 0.047).
“Sisters appeared to have the highest prevalence of [celiac disease] followed by daughters, sons, brothers, mothers, and fathers in that order,” the researchers wrote. Prevalence was significantly higher among sisters vs. brothers (14.1% vs. 6.2%; P = .005), and among daughters vs. brothers (13.3% vs. 6.2%; P = .02). Prevalence was also significantly higher among first-degree relatives in the U.S. compared with those from Europe, South America (both P < .001) and Asia (P = .001).
“The observations of this meta-analysis will help in risk stratification and developing screening strategies for [celiac disease] for [first-degree relatives],” the researchers wrote. “Such information will also help in selection of [first-degree relatives] for genetic studies … [and] also raise many interesting questions. While the risk of [celiac disease] in sisters of the index patient with [celiac disease] is high, is it unclear if the risk is further different if the index patient is brother or sister.” – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.