Gender-related differences in celiac disease presentation and follow-up in adult patients

BackgroundGender disparity has been documented in celiac disease (CD) with a female (F)-to-male (M) ratio of 2-2.5:1. Studies examining gender differences have yielded conflicting results. AimsTo investigate gender differences in clinical presentation at diagnosis, adherence to gluten-free diet (GFD), and modification of clinical symptoms with the GFD in adult CD patients. MethodsSingle-center retrospective study, including all consecutive CD patients referred to our Center between September 2022-July 2024. ResultsOne hundred and ninety-one patients, 141 F/50 M, mean age at diagnosis of 35.4/37.4 years, were included. In 59% F/54% M the diagnosis was prompted by gastrointestinal symptoms. At the diagnosis 13 F (9.1%) and 11 M (22%) were asymptomatic. Extra-intestinal manifestations were reported by 34 women (23.9%) and 6 men (12%). A low/absent adherence to GFD was reported by 17 women (12%) and 9 men (18%). Statistically significant differences were found regarding the prevalence of bone mineral density alterations (> in M, p-value = 0.017) and the degree of duodenal damage at the diagnosis (> in F, p-value = 0.021). ConclusionsOnly slight discrepancies in the clinical presentation at CD diagnosis between the two genders were identified, which are mostly resolved with the GFD. No significant difference with regard to dietary adherence between F/M was found.