Supplementary Material for: Celiac Disease and the Risk of Micronutrient Deficiencies in Ethnic Minority Populations: A Retrospective Cohort Study

Introduction Celiac disease (CD) is a chronic immune mediated disorder triggered by gluten ingestion in genetically predisposed individuals. Historically, CD was primarily recognized and described as a disease of the Caucasian population. Data from a national survey in 2015 revealed that 0.79% of the population was formally diagnosed with celiac disease, with the Non-Hispanic white population having a prevalence of 4-8 times higher than other underrepresented races. Although there is evidence that CD affects minorities at higher than reported rates, there is little data on it’s effects on minority populations. Our study aimed to characterize celiac-related complications among underrepresented populations in a large health database. Methods We performed a cohort study among patients aged ≥ 18, utilizing the TriNetX US Collaborative Network. Two cohorts of patients (minority and Non-Hispanic white) with CD were identified between 2016 and 2021. Cohorts were propensity score matched on demographics and baseline clinical characteristics. Outcomes were assessed up to one year after the index event (CD diagnosis), including vitamin/mineral deficiencies and hospital visits. Data were analyzed using the TriNetX Analytics function. Results Each group was matched with 817 patients. Compared to the Non-Hispanic White population, the minority group had a similar incidence of iron, vitamin B, and zinc deficiencies. The minority group had a higher risk of vitamin D deficiency, anemia secondary to iron deficiency, inpatient hospital stays, and emergency department visits. Conclusion Our results indicate that minority patients with celiac disease have a higher incidence of vitamin D and iron deficiency.