Brief Article
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World J Gastroenterol. Apr 21, 2013; 19(15): 2374-2378
Published online Apr 21, 2013. doi: 10.3748/wjg.v19.i15.2374
Seroprevalence of celiac disease among healthy adolescents in Saudi Arabia
Abdulrahman M Aljebreen, Majid A Almadi, Alwaleed Alhammad, Faleh Z Al Faleh
Abdulrahman M Aljebreen, Majid A Almadi, Faleh Z Al Faleh, Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh 11461, Saudi Arabia
Majid A Almadi, Gastroenterology Division, McGill University Health Center, Montreal General Hospital, McGill University, Montreal H3G 1A4, Canada
Alwaleed Alhammad, Immunology Unit, Department of Pathology, King Saud University, Riyadh 11461, Saudi Arabia
Author contributions: Aljebreen AM designed the study, analyzed the data and wrote the paper; Almadi MA analyzed the data and wrote the paper; Alhammad A conducted the blood test and revised the paper; Al Faleh FZ designed the study and wrote the paper.
Correspondence to: Abdulrahman M Aljebreen, FRCPC, FACP, Associate Professor of Internal Medicine, Consultant of Gastroenterology, Gastroenterology Division, King Khalid University Hospital, King Saud University, PO Box 2925, Riyadh 11461, Saudi Arabia. amaljebreen@gmail.com
Telephone: +966-1-4671215 Fax: +966-1-4671217
Received: December 6, 2012
Revised: January 22, 2013
Accepted: February 5, 2013
Published online: April 21, 2013
Processing time: 134 Days and 1.5 Hours
Abstract

AIM: To identify the seroprevalence of celiac disease among healthy Saudi adolescents.

METHODS: Between December 2007 and January 2008, healthy students from the 10th to 12th grades were randomly selected from three regions in Saudi Arabia. These regions included the following: (1) Aseer region, with a student population of 25512; (2) Madinah, with a student population of 23852; and (3) Al-Qaseem, with a student population of 16067. Demographic data were recorded, and a venous blood sample (5-10 mL) was taken from each student. The blood samples were tested for immunoglobulin A and immunoglobulin G endomysial antibodies (EMA) by indirect immunofluorescence.

RESULTS: In total, 1167 students (614 males and 553 females) from these three regions were randomly selected. The majority of the study population was classified as lower middle class (82.7%). There were 26 (2.2%) students who had a positive anti-EMA test, including 17 females (3.1%) and 9 males (1.5%). Al-Qaseem region had the highest celiac disease prevalence among the three studied regions in Saudi Arabia (3.1%). The prevalence by region was as follows: Aseer 2.1% (10/479), Madinah 1.8% (8/436), and Al-Qaseem 3.2% (8/252). The prevalence in Madinah was significantly lower than the prevalence in Aseer and Al-Qaseem (P = 0.02).

CONCLUSION: Our data suggest celiac disease prevalence might be one of the highest in the world. Further studies are needed to determine the real prevalence.

Keywords: Celiac disease; Saudi Arabia; Prevalence; Antiendomysial antibody; Epidemiology

Core tip: The celiac disease (CD) prevalence has progressively increased and, recently, it was proposed that it might be higher than 1 in 100. Until the 1990s, the prevalence of CD in Middle Eastern and North African countries was considered low. In this cohort of 1167 healthy young Saudi students who had anti-endomysial antibodies (EMA) test, the seroprevalence of celiac disease was 2.2% (1 in 45) and as high as 3.1% among females. Although intestinal biopsies were not available in our study, the high specificity of immunoglobulin A anti-EMA might indicate the celiac disease prevalence in Saudi Arabia might be one of the highest celiac disease prevalence rates in the world.