Dr. Benjamin Lebwohl, a researcher at the Celiac Disease Center at Columbia University Medical Center, and his colleagues found that celiac disease is the most common in U.S. patients with Punjabi ancestry. (Mailman.columbia.edu photo)

A study conducted by researchers at Columbia University Medical Center has identified the racial and ethnic distribution of celiac disease in the U.S. The findings revealed that celiac disease is the most common among patients with Punjabi ancestry.

About 1.8 million Americans have celiac disease, an immune-based condition caused by the consumption of gluten in genetically susceptible patients.

“While celiac disease was previously thought to be a disease predominantly affecting Caucasian Europeans, it is now recognized as one of the most common hereditary disorders worldwide,” said study author Dr. Benjamin Lebwohl, an assistant professor of medicine and epidemiology at the Celiac Disease Center at Columbia University Medical Center. “Our findings help shed light on the distribution of celiac disease in the U.S. and will aid gastroenterologists in diagnosing their patients.”

When a patient shows signs of celiac disease, a doctor does a biopsy in which several small pieces of tissue are sampled from the small intestine for examination with a microscope. The doctor then looks for villous atrophy, or damage to the wall of the small intestine, a finding which most often represents celiac disease.

For this study, Lebwohl and his colleagues looked at more than 400,000 intestinal biopsies from a nationwide database. They identified patients with celiac disease based on the presence of villous atrophy in the small intestine.

Using a previously published algorithm based on patient names, the researchers studied celiac disease distribution across these ethnicities: North Indian, South Indian, East Asian, Hispanic, Middle Eastern, Jewish and other Americans.

The researchers found that among the patients who underwent testing for celiac disease, the disease was most common among Americans from the Punjab region of India. The findings also showed that celiac disease was significantly less common among U.S. residents of South Indian, East Asian and Hispanic ancestry, while the rate of celiac disease among patients of Jewish and Middle Eastern ethnicities was similar to that of other Americans. Men and women had similar rates of celiac disease when tested, regardless of their ethnicity.

“While previous studies have suggested that celiac disease may be more common in female patients, based on our findings, we recommend that physicians consider celiac disease in men as often as they consider it in women,” noted Lebwohl.

The research was published in Clinical Gastroenterology and Hepatology, the official clinical practice journal of the American Gastroenterological Association.

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