ArticleGastroenterology2020
Community-Based Study of Celiac Disease Autoimmunity Progression in Adults.
Article in Gastroenterology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 28 citations in OpenAlex.
- Plasma Alkylresorcinols Is an Objective Biomarker for Gluten Intake in Young Children.The Journal of nutrition · 2025Trial
- Genome-Wide Transcriptomic Analysis of Intestinal Mucosa in Celiac Disease Patients on a Gluten-Free Diet and Postgluten Challenge.Cellular and molecular gastroenterology and hepatology · 2021Trial
- Challenges in the Pediatric Celiac Disease Diagnosis: An Up-to-Date Review.Diagnostics (Basel, Switzerland) · 2025Review
- Can diet change the natural history of gastrointestinal diseases?JGH open : an open access journal of gastroenterology and hepatology · 2024Review
- Coeliac disease: what can we learn from prospective studies about disease risk?The Lancet. Child & adolescent health · 2024Review
- Population level screening for celiac disease: is now the time?Current opinion in gastroenterology · 2023Review
- Celiac Disease in the Elderly.Current treatment options in gastroenterology · 2022Article
- Review article: Becoming and being coeliac-special considerations for childhood, adolescence and beyond.Alimentary pharmacology & therapeutics · 2022Review
- Coeliac disease re-screening among once seronegative at-risk relatives: A long-term follow-up study.United European gastroenterology journal · 2022Article
- The global burden of coeliac disease: opportunities and challenges.Nature reviews. Gastroenterology & hepatology · 2022Review
- Article
- Nutritional Status in Spanish Adults with Celiac Disease Following a Long-Term Gluten-Free Diet Is Similar to Non-Celiac.Nutrients · 2021Article
- AGA Technical Review on Gastrointestinal Evaluation of Iron Deficiency Anemia.Gastroenterology · 2020Review
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 3 countries.
Funding
Abstract
BACKGROUND &
aimsCeliac disease can develop at any age, but outcomes of adults with positive results from serologic tests for tissue transglutaminase antibodies (tTGA) without endoscopic determination of celiac disease (called celiac autoimmunity) have not been thoroughly evaluated. We investigated the proportion of adults with celiac autoimmunity at a community medical center and their progression to celiac disease.
methodsWe analyzed waste blood samples from a community clinic from 15,551 adults for tTGA and, if titer results were above 2 U/mL, for endomysial antibody. The blood samples had been collected at 2 time points (median interval, 8.8 years) from 2006 through 2017. We collected data from the clinic on diagnoses of celiac disease based on duodenal biopsy analysis.
resultsOf the serum samples collected at the first time point, 15,398 had negative results for tTGA, and 153 had positive results for tTGA (>4 U/mL). Based on medical records, 6 individuals received a diagnosis of celiac disease, for a cumulative incidence of celiac disease diagnosis of 0.06% (95% confidence interval, 0.01-0.11). Forty-nine (0.32%) individuals with a negative result from the first serologic test for tTGA had a positive result from the second test. Among the 153 adults who were tTGA positive at the first time point, 31 (20%) had a subsequent diagnosis of celiac disease, 81 (53%) remained positive for tTGA without a clinical diagnosis of celiac disease, and 41 (27%) had negative test results for tTGA at the second time point. Higher initial tTGA titers, female sex, and a history of hypothyroidism and autoimmune disease were associated with increased risks of subsequent diagnosis of celiac disease. Interestingly, adults whose first blood sample had a positive test result but second blood sample had a negative result for tTGA were older, had lower-than-average initial tTGA titer results, and had a higher mean body mass index than adults whose blood samples were positive for tTGA at both time points and adults later diagnosed with celiac disease.
conclusionsIn an analysis of serum samples collected from a community clinic an average of 8.8 years apart, we found that fewer than 1% of adults with negative results from an initial test for tTGA have a positive result on a second test. Of adults with positive results from the test for tTGA, only 20% are later diagnosed with celiac disease; the remaining individuals maintain persistent increases in tTGA without diagnoses of celiac disease or have negative results from second tests.
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