Why Do So Many Women Get Celiac Disease?

Celiac.com 07/12/2019 - In Italy, where gluten-rich pasta and pizza are king, the Italian Ministry of Health has presented its annual report on celiac disease to parliament. Celiac disease is a lifelong autoimmune condition in which people suffer an adverse reaction to gluten in wheat, rye or barley. The report contains some interesting details, especially in comparison to years past.

The 2017 report showed that women account for 145,759 of the 206,561 total cases of celiac disease, while men account for just 60,802 cases. So, what explains the difference? Why do women account for two out of three cases of celiac disease in Italy, and in many other places?

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The government suggests that women may be more susceptible than men to the disease due to biological differences between the two sexes.

Overall, researchers estimate that about one in 100 people have the condition. Common symptoms include stomach cramps, fatigue, constipation, diarrhea and vomiting, though more and more people was being diagnosed with few or no classical symptoms.

Research has shown that the female immune response is more developed and aggressive than the male immune response. The Italian researchers suggest that the vigilance of the female immune system might be related to women's biological role as child-bearers. The idea being that women developed a quicker and more robust response to infectious agents as a means to cope with post-natal infections, according to study authors, Simona de Stefano from the Ministry of Health, and Marco Silano from the National Institute of Health.

There is some research data that shows estrogen, the main female hormone, can play an active role against viruses, while testosterone, the main male hormone, can help to suppress inflammatory responses, the authors added.

There is also some evidence that variations in X and Y chromosomes may play a role. The combination of two X chromosomes potentially leaves women at greater risk for autoimmune diseases; while Y and X combination leaves men more susceptible to immunodeficiencies.

So, for now, according to the Italian Ministry of Health, the answer to the question of why women get celiac disease more often than men seems to be that women's immune systems leave them more genetically susceptible to celiac disease than men. 

"Women, who have more reactive immune systems than men, are more susceptible to coeliac disease," according to the Italian Ministry of Health. If, on the one hand, an immune system is so reactive and aggressive against infections, according to some scholars [it] can also more easily, and perhaps incorrectly modify itself in response to the infection," write the authors. This could result in excessive activation, which, over time, could lead to the development of autoimmune diseases, such as celiac disease, added de Stefano and Silano. 

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