BMJ. UK: The number of young children
diagnosed with coeliac disease in the UK has almost tripled over the
past 20 years, but kids from poorer families are only half as likely to
be diagnosed with the condition, reveals research published online in Archives of Disease in Childhood.
The
evidence to date suggests that up to 1% of all children in the UK have
blood markers for coeliac disease, an autoimmune reaction to dietary
gluten from wheat, barley, and rye.
In
a bid to assess current diagnostic patterns, the research team assessed
data contained in The Health Improvement Network (THIN), a
representative UK database of anonymised primary care health records.
They
identified all children from birth to the age of 18, registered with
general practices across the UK that contribute to THIN, between 1993
and 2012.
Among
the total of 2,063,421 children, 1247 had been diagnosed with coeliac
disease during this period, corresponding to around 1 new case in every
10,000 children every year.
This
case rate was similar across all four UK countries, and was 53% higher
among girls than among boys. Between 1993 and 2012, diagnoses rose by
39% in boys, but doubled in girls.
While
the numbers of new cases diagnosed in infants and toddlers remained
fairly stable across all four countries, diagnoses among children older
than 2 years almost tripled in the space of 20 years.The diagnosis rate
for coeliac disease in 2008-12 among children was 75% higher than it was
in 1993-97.
When
the researchers analysed the social and economic backgrounds of
children diagnosed with the condition, they found that those from less
well-off backgrounds were only half as likely to be diagnosed with the
condition. This pattern was evident for both boys and girls, and across
all ages.
The
researchers say the rise in new cases among children is likely to be
the result of better awareness of coeliac disease, as well as the means
to diagnose it. But this does not explain the differences in diagnoses
among children from different socioeconomic backgrounds, they say.
“Based
on the current evidence, the most plausible explanation for the
socioeconomic gradient in the incidence of childhood coeliac disease
whereby children from least deprived areas
have
[it] diagnosed more often than those from the most deprived areas is
that ascertainment of disease varies, rather than the true occurrence of
[coeliac disease],” they write.