Epidemiological, clinical, and histological presentation of celiac disease in Northwest China

Table 1 General information of included subjects

	Subjects, n (%)		Coeliac disease	Frequency	95%CI	P value
Ethnicity
Han	1097	38.0	6	0.55	0.1-1.0	< 0.001
Uygur	1048	36.3	23	2.19	1.3-3.1
Kazakh	387	13.5	17	4.39	2.3-6.4
Hui	283	9.8	2	0.71	0.0-1.7
Others	69	2.4	2	2.90	0.0-7.0
Gender
Male	1531	53.1	22	1.44	0.8-2.0	0.202
Female	1353	46.9	28	2.07	1.3-2.8
Age
0-19	283	9.8	3	1.06	0.0-2.3	0.135
20-39	727	25.2	16	2.20	1.1-3.3
40-59	989	34.3	22	2.22	1.3-3.1
≥ 60	885	30.7	9	1.02	0.4-1.7
BMI
≤ 18.49	159	5.5	14	8.81	4.4-13.3	< 0.001
18.5-23.99	1237	42.9	23	1.86	1.1-2.6
24-27.99	1064	36.9	7	0.66	0.2-1.1
≥ 28	424	14.7	6	1.42	0.3-2.5
Total	2884	100.0	50	1.73	1.3-2.2

Table 2 The modified Marsh–Oberhuber classification[24]

	Marsh 0	Marsh 1	Marsh 2	Marsh 3			Marsh 42
				3a	3b	3c
IEL count1	< 30/100	> 30/100	> 30/100	> 30/100	> 30/100	> 30/100	< 30/100
Crypt hyperplasia	-	-	+	+	+	+	-
Villous atrophy	-	-	-	Mild	Moderate	Total	Total
	Pre-infiltrative	Infiltrative	Infiltrative-hyperplastic	Flat destructive			Atrophic-hypoplastic

¹Number of intraepithelial lymphocytes per 100 enterocytes.

²This category is principally included for historic purposes.

IEL: Intraepithelial lymphocytes.

Table 3 General clinical symptoms and frequency of coeliac disease

Symptoms1	Subjects without coeliac disease (n = 2834), n (%)		Coeliac disease (n = 50), n (%)		P value	Total (n = 2884), n (%)		Frequency of coeliac disease among patients with symptoms (95%CI)	P value
Chronic diarrhea	258	9.1	21	42.0	< 0.001	279	9.7	7.53 (4.4-10.6)	< 0.001
Abdominal pain	1437	50.7	27	54.0	0.644	1464	50.8	1.84 (1.2-2.5)
Abdominal distension	1400	49.4	29	58.0	0.228	1429	49.5	2.03 (1.3-2.8)
Constipation	397	14.0	5	10.0	0.417	402	13.9	1.24 (0.2-2.3)
Anorexia	640	22.6	20	40.0	0.004	660	22.9	3.03 (1.7-4.3)
Vomit or/and nausea	802	28.3	18	36.0	0.231	820	28.4	2.20 (1.2-3.2)
Heartburn or/and acid reflux	740	26.1	12	24.0	0.736	752	26.1	1.60 (0.7-2.5)
Belch	776	27.4	13	26.0	0.828	789	27.4	1.65 (0.8-2.5)
Headache or/and dizziness	677	23.9	14	28.0	0.500	691	24.0	2.03 (1.0-3.1)
Anemia	416	14.7	20	40.0	< 0.001	436	15.1	4.59 (2.6-6.6)
Fatigue	536	18.9	24	48.0	< 0.001	560	19.4	4.29 (2.6-6.0)
Weight loss	873	30.8	24	48.0	0.009	897	31.1	2.68 (1.6-3.7)
Osteopenia or osteoporosis	329	11.6	38	76.0	< 0.001	367	12.7	10.35 (7.2-13.5)
Sleep disorder	771	27.2	23	46.0	0.003	794	27.5	2.90 (1.7-4.1)
Anxiety and depression	808	28.5	17	34.0	0.395	825	28.6	2.06 (1.1-3.0)
H. pylori infection	1627	57.4	24	48.0	0.182	1651	57.2	1.45 (0.9-2.0)

¹Note that patients had more than one symptom.

Table 4 Clinical signs and symptoms, celiac grading according to the presence of Helicobacter pylori in celiac disease patients

Symptom, sign, associatedcondition or, test	HP (+) (n = 24)	HP (-) (n = 26)	OR (95%CI)	P value
Chronic diarrhea	12 (50.0)	9 (34.6)	1.89 (0.61-5.89)	0.271
Abdominal pain	17 (70.8)	10 (38.5)	3.89 (1.19-12.68)	0.022
Abdominal distension	15 (62.5)	14(53.8)	1.43 (0.46-4.42)	0.536
Constipation	4 (16.7)	1 (3.8)	5.0 (0.52-48.34)	0.182
Anorexia	8 (33.3)	12 (46.2)	0.58 (0.19-1.84)	0.355
Vomit or/and nausea	11 (20.8)	7 (50.0)	2.30 (0.71-7.45)	0.164
Heartburn or/and acid reflux	8 (33.3)	4 (15.4)	2.75 (0.70-10.74)	0.138
Belch	6 (25.0)	7 (26.9)	0.91 (0.26-3.21)	0.877
Headache or/and dizziness	5 (20.8)	9 (34.6)	0.50 (0.14-1.78)	0.278
Anemia	8 (33.3)	12 (46.2)	0.58 (0.19-1.84)	0.355
Fatigue	11 (45.8)	13 (50.0)	0.85 (0.28-2.57)	0.768
Weight loss	10 (41.7)	14 (53.8)	0.61 (0.20-1.88)	0.389
Osteopenia or osteoporosis	20 (83.3)	18 (69.2)	2.22 (0.57-8.65)	0.243
Sleep disorder	11 (45.8)	12 (46.2)	0.99 (0.32-3.01)	0.982
Anxiety or/and depression	6 (25.0)	11 (42.3)	0.46 (0.14-1.52)	0.197
Celiac grading, No. (%)				0.032
Marsh grade 2 (n = 17)	12 (50.0)	5 (19.2)	1.0 (ref)
Marsh grade 3a (n = 16)	6 (25.0)	10 (38.5)	0.25 (0.06-1.07)
Marsh grade 3b (n = 13)	3 (12.5)	10 (38.5)	0.13 (0.02-0.66)
Marsh grade 3c (n = 4)	3 (12.5)	1 (3.8)	1.25 (0.10-15.11)

Patients may have one or more associated symptoms or conditions.