Racial Differences in the Prevalence of Celiac Disease in the US Population: National Health and Nutrition Examination Survey (NHANES) 2009–2012

Houssam E. Mardini, Philip Westgate, Alla Y. Grigorian

Research output: Contribution to journalArticlepeer-review

66 Scopus citations


Aim: To provide an estimate of the prevalence of celiac disease by race/ethnic origin in large sample of US population. Methods: Data from the 2009–2010 and 2011–2012 NHANES were combined and analyzed. The NHANES is a nationally representative survey with oversampling of certain minorities. Sample-based frequencies were reported and weighted frequencies were used to estimate prevalence. Results: A total of 14,701 participants were checked for tissue transglutaminase (tTG) and endomysial (EMA) IgA antibodies. Seventy-four participants had positive tTG and/or EMA corresponding to prevalence of 0.79 % (95 % CI 0.54–1.04 %). Non-Hispanic white were more likely to be positive for both compared with other races (72.0 vs 31.7 %; p = 0.010) and less likely to be weakly positive for tTG but positive for EMA (3.6 vs 26.4 %; p = 0.03). The prevalence of positive serology according to race was as follows: 1.08 % (95 % CI 0.70–1.45 %) in non-Hispanic white, 0.23 % (95 % CI 0.03–0.43 %) in Mexican, 0.22 % (95 % CI 0.01–0.44 %) in non-Hispanic black, 0.38 % (95 % CI 0.00–0.89 %) in “other Hispanic,” and 0.15 % (95 % CI 0.00–0.34 %) in other races including multiracial and undeterminable in non-Hispanic Asian due to the presence of only one positive EMA test. 0.9 % of the NHANES sample participants followed gluten-free diet. Of this group of participants, 85 % were never diagnosed with celiac disease and 99 % of them had negative celiac disease serology. Conclusions: Potentially 0.79 % of the general US population demonstrate serologic evidence of celiac disease autoimmunity. The prevalence is 4–8 times higher among non-Hispanic white compared with other races. Close to 1 % of the population is electively following gluten-free diet despite having little evidence of the disease.

Original languageEnglish
Pages (from-to)1738-1742
Number of pages5
JournalDigestive Diseases and Sciences
Issue number6
StatePublished - Jun 5 2015

Bibliographical note

Publisher Copyright:
© 2015, Springer Science+Business Media New York.


  • Celiac disease autoimmunity
  • Gluten
  • Racial differences

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology


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