Ethnic Variations in Duodenal Villous Atrophy Consistent With Celiac Disease in the United States

Anna Krigel, Kevin O. Turner, Govind K. Makharia, Peter H.R. Green, Robert M. Genta, Benjamin Lebwohl

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Background & Aims Celiac disease is a common disorder with a worldwide distribution, although the prevalence among different ethnicities varies. We aimed to measure the prevalence of duodenal villous atrophy among patients of different ethnicities throughout the United States. Methods We performed a cross-sectional study of all patients who had duodenal biopsies submitted to a national pathology laboratory between January 2, 2008 and April 30, 2015. The prevalence of villous atrophy was calculated for the following ethnicities by using a previously published algorithm based on patient names: North Indian, South Indian, East Asian, Hispanic, Middle Eastern, Jewish, and other Americans. Results Among all patients (n = 454,885), the median age was 53 years, and 66% were female. The overall prevalence of celiac disease was 1.74%. Compared with other Americans (n = 380,163; celiac disease prevalence, 1.83%), celiac disease prevalence was lower in patients of South Indian (n = 177, 0%; P = .08), East Asian (n = 4700, 0.15%; P ≤ .0001), and Hispanic (n = 31,491, 1.06%; P ≤ .0001) ethnicities. Celiac disease was more common in patients from the Punjab region (n = 617, 3.08%) than in patients from North India (n = 1195, 1.51%; P = .02). The prevalence of celiac disease among patients of Jewish (n = 17,806, 1.80%; P = .78) and Middle Eastern (n = 1903, 1.52%; P = .33) ethnicities was similar to that of other Americans. Among Jewish individuals (n = 17,806), the prevalence of celiac disease was 1.83% in Ashkenazi persons (n = 16,440) and 1.39% in Sephardic persons (n = 1366; P = .24). Conclusions Among patients undergoing duodenal biopsy, individuals from the Punjab region of India constitute the ethnic group in the United States with the highest prevalence of villous atrophy consistent with celiac disease. Compared with other Americans, villous atrophy prevalence on duodenal biopsy is significantly lower among U.S. residents of South Indian, East Asian, and Hispanic ancestry.

Original languageEnglish (US)
Pages (from-to)1105-1111
Number of pages7
JournalClinical Gastroenterology and Hepatology
Issue number8
StatePublished - Aug 1 2016
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2016 AGA Institute


  • Celiac Disease
  • Epidemiology
  • Ethnic Groups
  • Population


Dive into the research topics of 'Ethnic Variations in Duodenal Villous Atrophy Consistent With Celiac Disease in the United States'. Together they form a unique fingerprint.

Cite this