{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:48:26Z","timestamp":1791899306492,"version":"4.3.4"},"reference-count":151,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,6,18]],"date-time":"2023-06-18T00:00:00Z","timestamp":1687046400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006083","name":"AGA Research Foundation","doi-asserted-by":"publisher","award":["AGA2022\u201013\u201007"],"award-info":[{"award-number":["AGA2022\u201013\u201007"]}],"id":[{"id":"10.13039\/100006083","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Celiac disease is a global disease requiring genetic susceptibility and gluten exposure to trigger immune\u2010mediated enteropathy. The effect of the degree of gluten\u2010containing grain availability on celiac disease prevalence is unknown. Our objective was to compare country\u2010based gluten availability to celiac prevalence using a systematic literature review. We searched MEDLINE, Embase, Cochrane, and Scopus until May 2021. We included population\u2010based serum screening with confirmatory testing (second serological study or small intestine biopsy) and excluded specific, high\u2010risk, or referral populations. We determined country\u2010specific gluten availability using the United Nations food balance for wheat, barley, and rye. Human leukocyte antigen (HLA) frequencies were obtained from <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/allelefrequencies.net\">allelefrequencies.net<\/jats:ext-link>. The primary outcome was association between gluten\u2010containing grain availability and celiac disease prevalence. Generalized linear mixed models method with Poisson's link was used for analysis. We identified 5641 articles and included 120 studies on 427\u00a0146 subjects from 41 countries. Celiac disease prevalence was 0\u20133.1%, median 0.75% (interquartile range 0.35, 1.22). Median wheat supply was 246\u00a0g\/capita\/day (interquartile range 214.8, 360.7). The risk ratio (RR) for wheat availability on celiac disease was 1.002 (95% confidence interval [CI]: 1.0001, 1.004, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.036). A protective association was seen with barley, RR 0.973 (95% CI: 0.956, 0.99, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.003), and rye, RR 0.989 (95% CI: 0.982, 0.997, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.006). The RR for gross domestic product on celiac disease prevalence was 1.009 (95% CI: 1.005, 1.014, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). The RR for HLA\u2010DQ2 was 0.982 (95% CI: 0.979, 0.986, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), and that for HLA\u2010DQ8 was 0.957 (95% CI: 0.950, 0.964, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). In this geo\u2010epidemiologic study, gluten\u2010containing grain availability showed mixed associations with celiac disease prevalence.<\/jats:p>","DOI":"10.1111\/jgh.16260","type":"journal-article","created":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T01:54:25Z","timestamp":1687139665000},"page":"1695-1709","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Relationship between gluten availability and celiac disease prevalence: A geo\u2010epidemiologic systematic review"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6148-4203","authenticated-orcid":false,"given":"Claire L","family":"Jansson\u2010Knodell","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Digestive Disease and Surgery Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melis G","family":"Celdir","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology University of Iowa Hospitals and Clinics  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel A","family":"Hujoel","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruishen","family":"Lyu","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Gardinier","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Digestive Disease and Surgery Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kendra","family":"Weekley","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Digestive Disease and Surgery Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry J","family":"Prokop","sequence":"additional","affiliation":[{"name":"Mayo Clinic Libraries Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Rubio\u2010Tapia","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Digestive Disease and Surgery Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-301346"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000523"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S149181"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2005.083964"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2015.398"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2007.03502.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.03.059"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.10329"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.06.098"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.60"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000331"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000255"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/jcgh.2003.50004"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.11.013"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(92)91819-P"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2011.11.014"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkq1128"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2002.07023.x"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/927458"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-11-188"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2009.tb02491.x"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-004-1551-5"},{"key":"e_1_2_7_25_1","first-page":"325","article-title":"Seroprevalence of celiac disease in Belgian children and adolescents","volume":"75","author":"Vijgen S","year":"2012","journal-title":"Acta Gastroenterol. 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