Factors associated with serum antibodies to reticulin, endomysium, and gliadin in an adult population.

S A McMillan, R P Watson, E E McCrum, A E Evans

Regional Immunology Laboratory, Belfast City Hospital Trust.

BACKGROUND: Gluten sensitivity is thought to be significantly under-diagnosed in the population. AIMS: The aims of this study were to investigate the prevalence of antibodies associated with coeliac disease in a large representative sample of the adult population and to determine factors that are associated with their presence. PATIENTS: Serum samples from 5420 subjects with approximately equal numbers in each five year group from ages 15 to 65 years were obtained from the Belfast MONICA project and Change of Heart surveys, set up to monitor and assess risk factors associated with coronary heart disease in the population. METHODS: Using immunofluorescence and enzyme linked immunosorbent assay (ELISA) techniques autoantibodies, including those to reticulin, endomysium, and gliadin were determined. RESULTS: The results establish that IgA antigliadin antibody prevalence is high at 5.7%. Antiendomysial antibody was present in 1.2% of samples and gliadin and endomysial antibodies in 0.4%. No significant differences were found between men and women, area of residence in Northern Ireland or the year of sampling over the eight year period. However, there was a significant increase in the prevalence of IgA gliadin antibody, and to a lesser extent IgA endomysial antibody, with increasing age. CONCLUSION: The high prevalence of these positive antibodies suggests that coeliac disease may be relatively common in Northern Ireland.

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