Introduction The rate of diagnosis of coeliac disease in developed countries has increased dramatically since the introduction of serological tests without an obvious environmental precipitant. Little is known about the socio-economic distribution of coeliac disease; there is some evidence that it is less common in more deprived social groups.1 We quantified the incidence of new diagnoses of coeliac disease by socio-economic status in a large, contemporary and population-based cohort.

Methods The postcode of residence at diagnosis in consecutive incident adult cases of coeliac disease (n = 837) between January 2000 and December 2006 at Nottingham University Hospital and Royal Hallamshire Hospital was used to determine the Index of Multiple Deprivation 2007 (IMD07) score.2 Incidence rates were calculated using the total adult population for Sheffield and Nottingham derived from UK 2001 National Census categorised into corresponding IMD07 quintiles and Poisson models were fitted.

Results There was a strong, independent graded association between the incidence rate of new diagnoses of coeliac disease and socio-economic status. The incidence rate of coeliac disease was twice as high for the least deprived quintile (age- and sex-adjusted IRR* 1.93, 95% CI 1.61 to 2.44) compared with the most deprived quintile. Socio-economic status in incident coeliac disease was not associated with more severe coeliac disease (OR for quintile V to quintile I for presence of malabsorption 1.04, 95% CI 0.47 to 2.28; and for Marsh 3b, 3c histological change OR 0.87, 95% CI 0.56 to 1.34) (Abstract 091).

Conclusion The rate of new diagnoses of coeliac disease was twice as high in people from affluent areas compared with that in people living in poorer areas. This striking difference could be due to variation in environmental exposures such as breastfeeding practices3 or could be accounted for by differences in uptake and utilisation of health services.