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A study published this week in the New England Journal of Medicine sheds new light on the genetics behind celiac disease. Researchers found certain gene combinations put people at risk for the disease and that signs of the condition can be detected at a very early age.

Dr. Edwin Liu, a pediatric gastroenterologist at the CU School of Medicine and Children’s Hospital Colorado, says the benefit of detecting celiac disease early is that it can head off serious health problems later in life.

“If [celiac disease] is left untreated, individuals can develop thin bones like osteoporosis," Liu says. "They can have iron deficiency anemia, it can lead to infertility or miscarriages, and there’s actually a slightly increased risk of certain cancers of the small intestine."

About one in 100 people have the autoimmune disease that can damage the lining of the small intestine. People with the condition have to follow a strict gluten-free diet to avoid the protein that is found in wheat, rye and barley. Many people who don’t have the disease avoid gluten for other health reasons.

The study involved an international team of researchers and followed newborns in the United States, Germany, Finland and Sweden who had certain common gene combinations that put them at risk for the disease. The study found that one in four went on to actually develop signs of celiac disease.

Liu says of that group, not all will develop serious long-term complications if the condition is untreated, but he recommends they follow a gluten-free diet.

“The problem is we just don’t know who is and who isn’t going to develop serious complications in the future, and in children we just can’t afford to take that chance,” Liu says.

Currently, U.S. doctors recommend screening newborns at risk for celiac at the age of three. Liu says the findings suggest it should be done much earlier.

The study also found that the risk of developing celiac disease is twice as higher for Swedish children as for children in the United States.  Liu says that could be because of diet or anti-biotic use.

Liu says the findings raise more questions than answers, but he says researchers have made enormous progress in recent years toward understanding celiac disease.

“When I was in medical school, celiac disease was just a paragraph in a textbook,” Liu says. “Nowadays there are entire textbooks dedicated to the condition.”