Scandinavian Journal of Gastroenterology
Volume 46, Issue 7-8, 2011, Pages 844-848

Incidence of celiac disease among second-generation immigrants and adoptees from abroad in Sweden: Evidence for ethnic differences in susceptibility (Article)

Ji J.* , Ludvigsson J.F. , Sundquist K. , Sundquist J. , Hemminki K.
  • a Center for Primary Health Care Research, Lund University, Skåne University Hospital, 205 02 Malmö, Sweden
  • b Department of Pediatrics, Örebro University Hospital, Örebro, Sweden, Clinical Epidemiology Unit, Karolinska Institutet, Sweden
  • c Center for Primary Health Care Research, Lund University, Skåne University Hospital, 205 02 Malmö, Sweden
  • d Center for Primary Health Care Research, Lund University, Skåne University Hospital, 205 02 Malmö, Sweden, Stanford Prevention Research Center, Stanford University, School of Medicine, Stanford, CA, United States
  • e Center for Primary Health Care Research, Lund University, Skåne University Hospital, 205 02 Malmö, Sweden, Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany

Abstract

Background and aims. The incidence of celiac disease (CD) shows large, worldwide variation. However, whether its causes are environmental (gluten-containing diet) or genetic (specific haplotype) have not been established. The aim of the present study is to examine the incidence of CD among second-generation immigrants and adoptees from abroad to disentangle genetic/ethnic versus environmental influences (assuming that immigrants have similar gluten exposures to native Swedes, and thus differ from them only in terms of their genetic background). Methods. Second-generation immigrants and adoptees from abroad were identified in the MigMed 2 Database and were followed until diagnosis of CD, death, or the end of study. Standardized incidence ratios (SIRs) were calculated among these immigrants with native Swedes as the reference group. Results. A total of 1,050,569 children were defined as second-generation immigrants and the overall SIR of CD (SIR = 0.89, 95% confidence interval 0.840.94) was significantly lower than that of native Swedes. The incidence of CD among children with parents from Western, Eastern, and Northern European countries was similar to that in native Swedes, but was lower for those with parents from low-prevalence countries, especially Eastern and Southeast Asian countries. A total of 51,557 children born in foreign countries were adopted by Swedes. Adoptees from Eastern Asia had a significantly decreased SIR of CD. Conclusions. The decreased incidence of CD in second-generation immigrants and some groups of adoptees from abroad strongly suggests that ethnic genetic heterogeneity may contribute to the worldwide variation in CD incidence. © 2011 Informa Healthcare.

Author Keywords

Ethnic risk factors Sweden Follow-up Incidence Adoptee Celiac disease

Index Keywords

immigrant hospitalization Europe human risk assessment Asia data base priority journal celiac disease gluten adoption Family Characteristics Sweden North America school child ethnic difference Humans Emigrants and Immigrants Southeast Asia preschool child South America Genetic Predisposition to Disease high risk population prevalence Incidence Article major clinical study heredity disease predisposition cause of death standardized incidence ratio Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-79960254246&doi=10.3109%2f00365521.2011.579999&partnerID=40&md5=2d9a2115dda34615eecec84d5e7081af
DOI: 10.3109/00365521.2011.579999
ISSN: 00365521
Cited by: 20
Original Language: English