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Dietary Gluten Intake and Risk of Microscopic Colitis Among US Women without Celiac Disease: A Prospective Cohort Study
Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston MA, USA.
Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York NY, USA.
Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston MA, USA; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston MA, USA; Harvard Medical School, Boston MA, USA.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston MA, USA; South Australian Health and Medical Research Institute, Infection and Immunity Theme, School of Medicine, Flinders University, Adelaide SA, Australia.
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2019 (English)In: American Journal of Gastroenterology, ISSN 0002-9270, E-ISSN 1572-0241, Vol. 114, no 1, p. 127-134Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Microscopic colitis is a common cause of chronic watery diarrhea among the elderly. Although the prevalence of celiac disease appears to be higher in patients with microscopic colitis, the relationship between dietary gluten intake and risk of microscopic colitis among individuals without celiac disease has not been explored.

METHODS: We conducted a prospective study of 160,744 US women without celiac disease enrolled in the Nurses' Health Study (NHS) and the NHSII. Dietary gluten intake was estimated using validated food frequency questionnaires every 4 years. Microscopic colitis was confirmed through medical records review. We used Cox proportional hazard modeling to estimate the multivariable-adjusted hazard ratio (HR) and 95% confidence interval (CI).

RESULTS: We documented 219 incident cases of microscopic colitis over more than 20 years of follow-up encompassing 3,716,718 person-years (crude incidence rate: 5.9/100,000 person-years) in NHS and NHSII. Dietary gluten intake was not associated with risk of microscopic colitis (Ptrend = 0.88). Compared to individuals in the lowest quintile of energy-adjusted gluten intake, the adjusted HR of microscopic colitis was 1.18 (95% CI: 0.77-1.78) for the middle quintile and 1.03 (95% CI: 0.67-1.58) for the highest quintile. Additional adjustment for primary dietary sources of gluten including refined and whole grains did not materially alter the effect estimates (All Ptrend ≥ 0.69). The null association did not differ according to lymphocytic or collagenous subtypes (Pheterogeneity = 0.72) and was not modified by age, smoking status, or body mass index (All Pinteraction ≥ 0.17).

CONCLUSION: Dietary gluten intake during adulthood was not associated with risk of microscopic colitis among women without celiac disease.

Place, publisher, year, edition, pages
Blackwell Publishing, 2019. Vol. 114, no 1, p. 127-134
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:oru:diva-68919DOI: 10.1038/s41395-018-0267-5ISI: 000463156500019PubMedID: 30181535OAI: oai:DiVA.org:oru-68919DiVA, id: diva2:1247971
Note

Funding Agencies:

Crohn's and Colitis Foundation  

Crohn's and Colitis Foundation Senior Investigator Award  K24 DK098311 

Stuart and Suzanne Steele MGH Research Scholars Award  

Nurses' Health Study and Nurses' Health Study II  UM1 CA186107  UM1 CA176726 

National Health and Medical Research Council     F32 DK115134    K23 DK099681 

Available from: 2018-09-13 Created: 2018-09-13 Last updated: 2019-06-19Bibliographically approved

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Ludvigsson, Jonas F.

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