09:32am Friday 28 February 2020

Prevalence of celiac disease in China higher than expected

Celiac disease was considered to be rare in China and it had not been studied thoroughly, despite the fact that China is the world’s largest wheat producer and has a high and rapidly increasing consumption of wheat and gluten-containing products. This increasing consumption carries concomitant risks for the development of celiac disease. The results of this landmark study, which serves as a reference point for celiac disease in China, will be published on 4th December in the scientific journal PLOS ONE.

Celiac disease is an autoimmune disorder caused by genetically susceptible individuals consuming food and drinks made from wheat, barley or rye and therefore containing gluten. Gluten proteins can induce inflammation in the small intestine, hindering the uptake of nutrients, and can also disturb the normal functioning of other organs. In the Western world, the prevalence of celiac disease is between 0.5 and 2% of the population.

Wheat consumption is increasing rapidly in China due to urbanisation and westernization of the traditional Chinese diet but, until recently, the status of celiac disease had not been a major research subject. Wageningen UR initiated an investigation into the true status of celiac disease as a landmark reference point. It was conducted by the Chinese scientists, with help from the Dutch scientists. Three main issues were addressed by a systematic review and meta-analysis of the Chinese and international literature: the number of definite or suspected cases of the disease reported, the frequency of the major predisposing HLA genes seen in various Chinese populations, and the amount of wheat and gluten consumption, which is the major environmental factor.

The data strongly suggest that the prevalence of celiac disease is much higher in China than previously thought. The study also suggests that in the north-western regions of China, where there is the highest influx of Western (Caucasian) genes and the highest wheat consumption, celiac disease will be more frequent and have prevalences similar to those seen in Western societies. The disease prevalence is likely to rise as the Chinese adopt a more Western life style, with increased consumption of wheat and gluten-containing products. This will be true throughout the country, but especially in urban environments. These factors mean China is a country at risk of celiac disease becoming a common disease and strategies for prevention should be developed to guarantee the health of Chinese individuals.

Wageningen UR initiated this study, which was carried out by Nanchang University and supported by the University Medical Centre Groningen, within the framework of the Dutch Celiac Disease Consortium. This research was partly funded by the Dutch government through the Netherlands Genomics Initiative, and partly by the Chinese government through the International Science & Technology Cooperation Program of China (No. 2013DFG31380), and the National High Technology Research and Development Program of China (863 Program, No. 2013AA102205).

The mission of Wageningen UR (University & Research centre) is ‘To explore the potential of nature to improve the quality of life’. Within Wageningen UR, nine research institutes – both specialised and applied – have joined forces with Wageningen University to help answer the most important questions in the domain of healthy food and living environment. With approximately 40 locations (in the Netherlands, Brazil and China), 6500 members of staff and 10,000 students, Wageningen UR is one of the leading organisations in its domain worldwide. The integral approach to problems and the cooperation between the exact sciences and the technological and social disciplines are at the heart of the Wageningen Approach.

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