Digestive Diseases and Sciences

, Volume 59, Issue 7, pp 1509–1512 | Cite as

Celiac Disease Is Diagnosed Less Frequently in Young Adult Males

  • Rohit Dixit
  • Benjamin Lebwohl
  • Jonas F. Ludvigsson
  • Suzanne K. Lewis
  • Norelle Rizkalla-Reilly
  • Peter H. R. Green
Original Article



The female predominance in celiac disease is difficult to explain because population-based screening studies reveal similar rates for celiac disease-specific autoantibodies in males and females.


The aim of this study was to explore the role of age and gender in the presentation of celiac disease.


The frequency of presentation according to age, gender and mode of presentation was determined by analysis of a prospectively maintained database of children and adults seen at a tertiary medical center.


Of 1,682 patients (68 % female) aged 3 months to 86 years who were diagnosed with celiac disease, age at diagnosis in females peaked at 40–45 years, whereas the age at diagnosis for males had two peaks: 10–15 and 35–40 years. A significantly lower percentage of males in early adulthood were diagnosed compared with males in all other age groups (P < 0.0001). The young and elderly had a more even gender distribution.


Based on our analysis, males are diagnosed with celiac disease less frequently than females, especially in early adulthood. There should be more emphasis on the diagnosis of celiac disease among young adult males.


Celiac disease Gender Diagnosis Epidemiology 


Conflict of interest



  1. 1.
    Jabri B, Sollid LM. Mechanisms of disease: immunopathogenesis of celiac disease. Nat Clin Pract Gastroenterol Hepatol. 2006;3:516–525.PubMedCrossRefGoogle Scholar
  2. 2.
    Green PHR, Cellier C. Celiac disease. N Engl J Med. 2007;357:1731–1743.PubMedCrossRefGoogle Scholar
  3. 3.
    Mäki M, Mustalahti K, Kokkonen J, et al. Prevalence of celiac disease among children in Finland. N Engl J Med. 2003;348:2517–2524.PubMedCrossRefGoogle Scholar
  4. 4.
    West J, Logan RFA, Hill PG, et al. Seroprevalence, correlates, and characteristics of undetected coeliac disease in England. Gut. 2003;52:960–965.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Jamma S, Rubio-Tapia A, Kelly CP, et al. Celiac crisis is a rare but serious complication of celiac disease in adults. Clin Gastroenterol Hepatol. 2010;8:587–590.PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Ludvigsson JF, Leffler DA, Bai JC, et al. The Oslo definitions for coeliac disease and related terms. Gut. 2013;62:43–52.PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Green PHR, Stavropoulos SN, Panagi SG, et al. Characteristics of adult celiac disease in the USA: results of a national survey. Am J Gastroenterol. 2001;96:126–131.PubMedCrossRefGoogle Scholar
  8. 8.
    Murray JA, Van Dyke C, Plevak MF, Dierkhising RA, Zinsmeister AR, Melton LJ. Trends in the identification and clinical features of celiac disease in a North American community, 1950–2001. Clin Gastroenterol Hepatol. 2003;1:19–27.PubMedCrossRefGoogle Scholar
  9. 9.
    Ciacci C, Cirillo M, Sollazzo R, Savino G, Sabbatini F, Mazzacca G. Gender and clinical presentation in adult celiac disease. Scand J Gastroenterol. 1995;30:1077–1081.PubMedCrossRefGoogle Scholar
  10. 10.
    Rubio-Tapia A, Kyle RA, Kaplan EL, et al. Increased prevalence and mortality in undiagnosed celiac disease. Gastroenterology. 2009;137:88–93.PubMedCentralPubMedCrossRefGoogle Scholar
  11. 11.
    Fasano A, Berti I, Gerarduzzi T, et al. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med. 2003;163:286–292.PubMedCrossRefGoogle Scholar
  12. 12.
    Walker MM, Murray JA, Ronkainen J, et al. Detection of celiac disease and lymphocytic enteropathy by parallel serology and histopathology in a population-based study. Gastroenterology. 2010;139:112–119.PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Lohi S, Mustalahti K, Kaukinen K, et al. Increasing prevalence of coeliac disease over time. Aliment Pharmacol Ther. 2007;26:1217–1225.PubMedCrossRefGoogle Scholar
  14. 14.
    Katz KD, Rashtak S, Lahr BD, et al. Screening for celiac disease in a North American population: sequential serology and gastrointestinal symptoms. Am J Gastroenterol. 2011;106:1333–1339.PubMedCentralPubMedCrossRefGoogle Scholar
  15. 15.
    Not T, Horvath K, Hill ID, et al. Celiac disease risk in the USA: high prevalence of antiendomysium antibodies in healthy blood donors. Scand J Gastroenterol. 1998;33:494–498.PubMedCrossRefGoogle Scholar
  16. 16.
    White LE, Merrick VM, Bannerman E, et al. The rising incidence of celiac disease in Scotland. Pediatrics. 2013;132:e924–e931.PubMedCrossRefGoogle Scholar
  17. 17.
    Mankaï A, Landolsi H, Chahed A, et al. Celiac disease in Tunisia: serological screening in healthy blood donors. Pathol Biol (Paris). 2006;54:10–13.CrossRefGoogle Scholar
  18. 18.
    Bahari A, Karimi M, Sanei-Moghaddam I, Firouzi F, Hashemi M. Prevalence of celiac disease among blood donors in Sistan and Balouchestan Province, Southeastern Iran. Arch Iran Med. 2010;13:301–305.PubMedGoogle Scholar
  19. 19.
    Gandolfi L, Pratesi R, Cordoba JC, Tauil PL, Gasparin M, Catassi C. Prevalence of celiac disease among blood donors in Brazil. Am J Gastroenterol. 2000;95:689–692.PubMedCrossRefGoogle Scholar
  20. 20.
    Weile I, Grodzinsky E, Skogh T, Jordal R, Cavell B, Krasilnikoff PA. High prevalence rates of adult silent coeliac disease, as seen in Sweden, must be expected in Denmark. APMIS. 2001;109:745–750.PubMedCrossRefGoogle Scholar
  21. 21.
    Melo SBC, Fernandes MIM, Peres LC, Troncon LEA, Galvão LC. Prevalence and demographic characteristics of celiac disease among blood donors in Ribeirão Preto, State of São Paulo, Brazil. Dig Dis Sci. 2006;51:1020–1025.PubMedCrossRefGoogle Scholar
  22. 22.
    Alencar ML, Ortiz-Agostinho CL, Nishitokukado L, et al. Prevalence of celiac disease among blood donors in São Paulo: the most populated city in Brazil. Clinics (Sao Paulo). 2012;67:1013–1018.CrossRefGoogle Scholar
  23. 23.
    Sárdy M, Kornseé Z, Kelemen D, Papp S, Medvecz M, Kárpáti S. Celiac disease screening among healthy blood donors in Hungary. Z Gastroenterol. 2013;51:1235–1239.PubMedCrossRefGoogle Scholar
  24. 24.
    Kochhar R, Sachdev S, Kochhar R, et al. Prevalence of coeliac disease in healthy blood donors: a study from north India. Dig Liver Dis. 2012;44:530–532.PubMedCrossRefGoogle Scholar
  25. 25.
    Shamir R, Lerner A, Shinar E, et al. The use of a single serological marker underestimates the prevalence of celiac disease in Israel: a study of blood donors. Am J Gastroenterol. 2002;97:2589–2594.PubMedCrossRefGoogle Scholar
  26. 26.
    Drossman DA, Li Z, Andruzzi E, et al. U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci. 1993;38:1569–1580.PubMedCrossRefGoogle Scholar
  27. 27.
    Lockshin MD. Sex differences in autoimmune disease. Lupus. 2006;15:753–756.PubMedCrossRefGoogle Scholar
  28. 28.
    Bai D, Brar P, Holleran S, Ramakrishnan R, Green PHR. Effect of gender on the manifestations of celiac disease: evidence for greater malabsorption in men. Scand J Gastroenterol. 2005;40:183–187.PubMedCrossRefGoogle Scholar
  29. 29.
    Juel K, Christensen K. Are men seeking medical advice too late? Contacts to general practitioners and hospital admissions in Denmark 2005. J Public Health (Oxf). 2008;30:111–113.CrossRefGoogle Scholar
  30. 30.
    Oksuzyan A, Juel K, Vaupel JW, Christensen K. Men: good health and high mortality. Sex differences in health and aging. Aging Clin Exp Res. 2008;20:91–102.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Rohit Dixit
    • 1
  • Benjamin Lebwohl
    • 1
  • Jonas F. Ludvigsson
    • 3
    • 4
  • Suzanne K. Lewis
    • 1
  • Norelle Rizkalla-Reilly
    • 2
  • Peter H. R. Green
    • 1
    • 5
  1. 1.Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and SurgeonsColumbia UniversityNew YorkUSA
  2. 2.Department of Pediatrics, Celiac Disease Center, Columbia University College of Physicians and SurgeonsColumbia UniversityNew YorkUSA
  3. 3.Clinical Epidemiology Unit, Department of MedicineKarolinska University Hospital–Karolinska InstitutetStockholmSweden
  4. 4.Department of PediatricsÖrebro University HospitalÖrebroSweden
  5. 5.NewYork-Presbyterian HospitalNew YorkUSA

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