Coeliac disease in Asians in a single centre in southern Derbyshire

Holmes, Geoffrey; Moor, Fiona

doi:10.1136/flgastro-2012-100200

Cited by 4 publications

(17 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…36 A full epidemiological analysis of Asians has not been undertaken in this new study because the ONS has not yet published population estimates by ethnicity beyond 2010. However, the data collected are informative.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of coeliac disease in a single centre in Southern Derbyshire 1958–2014

Holmes

Muirhead

2017

BMJ Open Gastroenterol

View full text Add to dashboard Cite

ObjectiveTo determine trends in diagnosis of coeliac disease (CD) in patients attending a single centre 1958–2014 and provide figures for prevalence and incidence in those born in Derby city over 4 decades. To explore a link between deprivation and prevalence and characteristics of CD in Asians.DesignAn unselected, consecutive series of 2410 adult patients with CD diagnosed in the catchment area of the Derby hospitals was identified. 1077 born within Derby city identified by postcodes was used to determine changes in prevalence and incidence over 4 decades. 191 patients were Asian. Population numbers were obtained from National Census information.ResultsIn the quinquennium 2010–2014, 20 times more patients were diagnosed than during 1975–1979. 27% were diagnosed at ≥60 years. A paucity of diagnoses in young men was observed. Women were diagnosed most often in age band ≥35<45, 15 years earlier than men. The largest increase in diagnosis rates occurred in young women and the elderly. In 2014, overall prevalence was 1:188; women 1:138. 4.6% of the variation was attributed to deprivation. Diagnosis rates in Asians increased markedly although only 5% were diagnosed at ≥60 years, much lower than for whites.ConclusionsThe dramatic increase in number of patients with CD presents challenges for follow-up and new models of care need to be explored. Healthcare workers should be alert to the diagnosis in young men and elderly Asians. A dedicated coeliac clinic is an excellent facility to increase diagnosis rates.

show abstract

Section: Discussionmentioning

confidence: 99%

Epidemiology of coeliac disease in a single centre in Southern Derbyshire 1958–2014

Holmes

Muirhead

2017

BMJ Open Gastroenterol

View full text Add to dashboard Cite

show abstract

“…The results of the present study regarding the difference in rates of dietary adherence between Asian and Caucasian patients with coeliac disease corroborate the results of the study by Holmes et al . , although they demonstrate a greater difference in the rates of dietary adherence between the two populations. Our results differ from the results of the study by Muhammad et al .…”

Section: Discussionmentioning

confidence: 74%

“…The results of the present study are being reported in the context of recent studies on dietary adherence in South Asian patients with coeliac disease, including studies by Butterworth et al . , Holmes and Moor and Muhammad et al . .…”

Section: Discussionmentioning

confidence: 96%

“… did not find difference in dietary adherence between South Asian and Caucasian patients with coeliac disease. The study by Holmes and Moor using expert assessment found significantly lower rates of strict adherence to gluten‐free diet in South Asian patients with coeliac disease than Caucasian patients.…”

Section: Discussionmentioning

confidence: 99%

“…That study used the validated Coeliac Disease Adherence Test to indicate adherence, although it was reliant on a response to a postal invitation and found significant differences between the groups in terms of the response rate. A study by Holmes and Moor , relying on reviews by an experienced dietitian to assess adherence, found that a significantly smaller number of South Asian patients with coeliac disease were fully adherent with a gluten‐free diet than Caucasian patients. Butterworth et al .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Coeliac disease in Caucasian and South Asian patients in the North West of England

Adam

Melgies

Kadir

et al. 2019

J Human Nutrition Diet

View full text Add to dashboard Cite

Background Coeliac disease is an autoimmune enteropathy characterised by mucosal inflammation subsequent to gluten exposure, leading to malabsorption. Treatment is strict dietary control, relying on the patient's ability to maintain lifestyle modifications. The present study aimed to compare clinical presentation and adherence to a gluten‐free diet between South Asian and Caucasian patients with coeliac disease in East Lancashire Methods In total, 33 South Asian and 113 Caucasian adult patients diagnosed with coeliac disease under the care of the Dietetics Department at East Lancashire Hospitals NHS Trust were selected using a convenience sampling method and then allocated to the South Asian or Caucasian group. A subjective assessment of dietetic notes from follow‐up visits within 1 year of the first appointment was undertaken by two investigators who subsequently allocated the patients to one of the three categories: (i) fully‐adherent; (ii) partly‐adherent; and (iii) non‐adherent. Presenting complaint, vitamin D, vitamin B12, folate and ferritin levels were also compared. Results There was a significant difference in adherence to gluten‐free diet between the groups, with a larger proportion of Caucasian patients being fully adherent to gluten‐free diet compared to South Asian patients (64.6% versus 12.1%, P < 0.001). In addition, a significantly higher proportion of South Asian patients were vitamin D deficient compared with Caucasian patients (70.8% versus 32.8%, P = 0.002). Conclusions The rates of strict adherence to gluten‐free diet and vitamin D levels were significantly lower in South Asian patients with coeliac disease compared to the Caucasian coeliac population. Further studies are required to investigate the causes and improve adherence in the South Asian population.

show abstract

Identifying and improving adherence to the gluten-free diet in people with coeliac disease

2019

View full text Add to dashboard Cite

Coeliac disease (CD) is an autoimmune gastrointestinal disorder whereby the ingestion of gluten, a storage protein found in wheat, barley and rye, causes damage to intestinal mucosa with resultant malabsorption, increased risk of anaemia and osteoporosis. Worldwide estimates suggest 1% of the population have CD. With no cure, the only treatment is a gluten-free diet (GFD). Adhering to a GFD can be very challenging; it requires knowledge, motivation and modified behaviours. Assessing adherence to a GFD is methodologically challenging. This review aims to provide an overview of the literature reporting adherence to a GFD in people with CD and the methodological challenges encountered. From six studies it has been reported that rates of adherence to a GFD range between 45 and 90% in patients of different ethnicities with CD. GF dietary adherence can be influenced by age at diagnosis, coexisting depression, symptoms on ingestion of gluten, nutrition counselling, knowledge of GF foods, understanding of food labels, cost and availability of GF foods, receiving GF foods on prescription and membership of a coeliac society. To date only five intervention studies in adults with CD have been undertaken to improve GF dietary adherence. These have included dietary and psychological counselling, and the use of online training programmes, apps, text messages and telephonic clinics. Future interventions should include people of all ethnicities, consider patient convenience and the cost-effectiveness for the healthcare environment.

show abstract

Coeliac disease in Asians in a single centre in southern Derbyshire

Abstract: Background Coeliac disease affects adult Asians from north India, Pakistan and Bangladesh in the UK but how commonly this occurs is unknown.

Cited by 4 publications

References 12 publications

Epidemiology of coeliac disease in a single centre in Southern Derbyshire 1958–2014

Epidemiology of coeliac disease in a single centre in Southern Derbyshire 1958–2014

Coeliac disease in Caucasian and South Asian patients in the North West of England

Identifying and improving adherence to the gluten-free diet in people with coeliac disease

Contact Info

Product

Resources

About