{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:41:40Z","timestamp":1780468900495,"version":"3.54.1"},"reference-count":58,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,7,18]],"date-time":"2021-07-18T00:00:00Z","timestamp":1626566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002341","name":"Academy of Finland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Family screening has been advocated as a means to reduce the major underdiagnosis of coeliac disease. However, the precise risk of the disease in relatives and the impact of patient\u2010 and relative\u2010related individual factors remain obscure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate the individual risk of coeliac disease among patients' relatives.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Altogether 2943 relatives of 624 index patients were assessed for the presence of previous coeliac disease diagnosis, or were screened for the disease. Coeliac disease\u2010associated human leucocyte antigen (HLA) genotype was determined from all participants. The association between individual factors and new screening positivity was assessed by logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 229 previously diagnosed non\u2010index relatives with coeliac disease and 2714 non\u2010affected (2067 first\u2010degree, 647 more distant) relatives. Of these 2714 relatives, 129 (4.8%) were screening\u2010positive (first\u2010degree 5.1%, second\u2010degree 3.6%, more distant 3.5%). The combined prevalence of the previously diagnosed and now detected cases in relatives was 12.2% (6.3% clinically detected, 5.9% screen\u2010detected). In univariate analysis, age &lt;18\u00a0years at diagnosis (odds ratio 1.60, 95% CI 1.04\u20102.45) in index, and age 41\u201060\u00a0years (1.73, 1.10\u20102.73), being a sibling (1.65, 1.06\u20102.59) and having the high\u2010risk genotype (3.22, 2.01\u20105.15 DQ2.5\/2.5 or DQ2.5\/2.2 vs other risk alleles) in relatives were associated with screening positivity. Only high\u2010risk HLA remained significant (2.94, 1.80\u20104.78) in multivariable analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Unrecognised coeliac disease was common among at\u2010risk relatives even in a country with an active case\u2010finding policy, and also in relatives more distant than first\u2010degree. The presence of a high\u2010risk genotype was the most important predictor for screening positivity. ClinicalTrials.gov identifier NCT03136731.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16534","type":"journal-article","created":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T06:51:28Z","timestamp":1626677488000},"page":"805-813","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Presence of high\u2010risk HLA genotype is the most important individual risk factor for coeliac disease among at\u2010risk relatives"],"prefix":"10.1111","volume":"54","author":[{"given":"Saana","family":"Paavola","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health Technology University of Tampere and Tampere University Hospital Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katri","family":"Lindfors","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology University of Tampere and Tampere University Hospital Tampere 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