Brief Article
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World J Gastroenterol. Mar 28, 2013; 19(12): 1930-1935
Published online Mar 28, 2013. doi: 10.3748/wjg.v19.i12.1930
Decreased prevalence of celiac disease among Brazilian elderly
Lucas Malta Almeida, Luiz Claudio Castro, Rosa Harumi Uenishi, Fernanda Coutinho de Almeida, Patricia Maria Fritsch, Lenora Gandolfi, Riccardo Pratesi, Yanna Karla de Medeiros Nóbrega
Lucas Malta Almeida, Fernanda Coutinho de Almeida, Patrícia Maria Fritsch, Graduate Program in Medical Sciences, University of Brasilia School of Medicin, Brasilia DF 70910900, Brazil
Lucas Malta Almeida, Fernanda Coutinho de Almeida, Patrícia Maria Fritsch, Doctoral fellow of Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Brasilia DF 70910900, Brazil
Luiz Claudio Castro, Rosa Harumi Uenishi, Lenora Gandolfi, Riccardo Pratesi, Graduate Program in Health Sciences, University of Brasilia School of Health Sciences, Brasilia DF 70910900, Brazil
Luiz Claudio Castro, Rosa Harumi Uenishi, Lenora Gandolfi, Riccardo Pratesi, Research Center for Celiac disease, University of Brasilia School of Medicine, Brasilia DF 70910900, Brazil
Yanna Karla de Medeiros Nóbrega, Department of Pharmaceutical Sciences, University of Brasilia School of Health Sciences, Brasilia DF 70910900, Brazil
Yanna Karla de Medeiros Nóbrega, Research Center for Celiac Disease, University of Brasilia School of Medicine, Brasilia DF 70910900, Brazil
Author contributions: Gandolfi L and Pratesi R had the original idea and made substantial contributions to the conception and design of the study; Almeida LM wrote the study protocol and, along with Gandolfi L, wrote the initial version of the paper; Almeida LM, Uenishi RH and de Almeida FC collected the laboratory samples and did the laboratory work; de Medeiros Nóbrega YK supervised the laboratory work, analyzed clinical and laboratory data, performed the statistical analysis, and performed the final critical review of the paper; Castro LC and Pratesi R wrote the final version of the paper; all authors have seen and approved the final version of the paper.
Correspondence to: Yanna Karla de Medeiros Nóbrega, PhD, Professor, Department of Pharmaceutical Sciences, University of Brasilia School of Health Sciences, SQN 314 Bloco E Apt 501 Asa Norte, Brasilia DF 70910900, Brazil. yannanobrega@gmail.com
Telephone: +55-61-31071991 Fax: +55-61-31071991
Received: June 21, 2012
Revised: December 3, 2012
Accepted: December 12, 2012
Published online: March 28, 2013
Abstract

AIM: To evaluate the prevalence of celiac disease in a group of Brazilian individuals over 60 years of age and compare it with the previously known prevalence in a pediatric group living in the same geographical area.

METHODS: The research protocol was approved by the Ethics Committee of the University of Brasilia School of Medicine, Brasilia, Brazil. Blood samples from 946 individuals (295 male and 651 female) aged 60 years or older were collected between May 2010 and July 2011. The study subjects’ mean and median ages were 68.1 and 67 years, respectively, ranging from 60 to 92 years. That age distribution closely corresponded to the age distribution of the Brazilian population according to the Brazilian 2010 census. The participants were consecutive and unselected outpatients undergoing blood tests at the University of Brasilia Hospital’s Clinical Pathology Laboratory. All sera were tested for immunoglobulin A anti-transglutaminase antibodies (IgA-tTG) by enzyme- linked immunosorbent assay, and those that were positive were further tested for immunoglobulin A anti-endomysium antibodies (IgA-EMA). Human leukocyte antigen (HLA) genotyping was performed for all individuals who exhibited positive serologic results for IgA-tTG and/or IgA-EMA.

RESULTS: Out of the 946 studied patients, only one previously diagnosed case of biopsy-proven celiac disease was detected. For the remaining subjects, nine serum samples tested positive for IgA-tTG antibodies; however, none of them tested positive for IgA-EMA antibodies. The HLA genotyping of those nine subjects revealed that one was carrying DQA1*0501 and two were carrying DQB1*0201 alleles. These data showed that, among those 946 elderly individuals, the prevalence of celiac disease (CD) was 0.1% (95%CI: 0.00-0.59). The prevalence of CD for the elderly group was compared with that observed for the group of 2034 children younger than 15 years (age range, 1-14 years; mean age, 8 years) who took part in our previous CD prevalence screening study. All the children came from the same geographical region and shared a similar ethnic and low-income background. As in the elderly group in the current study, the younger group was made up of consecutive outpatients who underwent blood evaluation at the University of Brasilia Hospital’s Clinical Laboratory. The prevalence of biopsy-proven CD among those children was 0.54% (95%CI: 0.27-0.57). The comparative analysis between the two groups resulted in the following values: odds ratio = 0.19 (95%CI: 0.01-1.45) Fisher test P = 0.06.

CONCLUSION: The prevalence of CD among the children of our previous study was 5.4 times higher than that found in the present elderly group.

Keywords: Celiac disease, Gluten-sensitive enteropathy, Epidemiology, Elderly, Mortality