Prevalence of celiac disease in China higher than expected

In China, celiac disease is more common than currently reported, conclude researchers of Nanchang University (China), together with Dutch scientists of Wageningen UR (University & Research centre) and the University Medical Centre Groningen, after conducting the first systematic review and meta-analysis of Chinese and international literature on the disease occurrence. Until now, celiac disease was considered to be rare in China and it has not been investigated thoroughly, despite the fact that China is the world’s largest wheat producer and has a high consumption of wheat and gluten-containing products. Wheat consumption is now increasing rapidly, with concomitant increasing risks for development of this disease. The results of this study, which can be regarded as a landmark reference point for celiac disease in China, will be published on 4^th December in the scientific journal PLOS ONE. The work was performed in the framework of the Dutch Celiac Disease Consortium.

Celiac disease is an autoimmune disorder caused by the consumption of food and drinks made from the gluten-containing grains wheat, barley and rye. Gluten proteins can induce inflammation in the small intestine, hindering uptake of food components, and can also disturb the normal functioning of other organs. In the Western world, the prevalence of celiac disease is between 0.5 and 2% of the population.

Currently, wheat and gluten consumption is increasing rapidly in China due to urbanisation, and westernizing of the traditional Chinese diet. Until recently, the status of celiac disease had not been a major research subject. Wageningen UR initiated the investigation, which was conducted by the Chinese scientists, of the true status of celiac disease as a landmark reference point. Three main issues were addressed by a systematic review and meta-analysis of the Chinese and international literature: the number of reported definite or suspected cases of the disease, the frequency of occurrence of the major predisposing HLA genes in various Chinese populations, and the consumption of wheat and gluten as the major environmental factor.

The data strongly suggest that the prevalence of celiac disease is much higher in China than previously thought. The study also suggests that in the north-western regions of China, where there is the highest influx of western (Caucasian) genes and the highest wheat consumption, celiac disease will be more common with prevalences similar to Western societies. Further, the prevalence is likely to rise as the Chinese in general, but especially in urban environments, adopt a more Western life style, with increased consumption of wheat and gluten-containing food products. These factors make China a country at risk of developing celiac disease as a common disease; strategies for prevention should be developed to guarantee the health and quality of life of Chinese individuals.

Wageningen UR initiated this study that was carried out by Nanchang University, supported by University Medical Centre Groningen, in the framework of the Dutch Celiac Disease Consortium. This research was partly funded by the Dutch government through the Netherlands Genomics Initiative and by the Chinese government.

The tip of the “celiac iceberg” in China: a systematic review and meta-analysis

full text, PLOS ONE, Dec. 2013

by Juanli Yuan ^1,2, Jinyan Gao ³,Xin Li ^1,3, Fahui Liu ¹, Cisca Wijmenga ⁴, Hongbing Chen ^1,5, Luud JWJ Gilissen ⁶

¹ State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, Jiangxi, China
² Collegeof Pharmaceutical Sciences, Nanchang University, Nanchang, Jiangxi, China
³ School of Life Sciences and Food Engineering, Nanchang University, Nanchang, Jiangxi, China
⁴ Department of Genetics, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
⁵ Sino-German Joint Research Institute, Nanchang University, Nanchang, Jiangxi, China
⁶ Plant Research International, Wageningen University & Research Centre, Wageningen, The Netherlands.

For more information please contact Prof. C Wijmenga, Dept of Genetics, UMCG, Phone: +31 (0)50-3617245, Email