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A nationwide cohort study of the risk of chronic obstructive pulmonary disease in coeliac disease
Department of Paediatrics, Örebro University Hospital, Örebro, Sweden; Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0003-1024-5602
Section for Respiratory Medicine AND Allergology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden.
Section for Respiratory Medicine AND Allergology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden.
Section for Respiratory Medicine AND Allergology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden.
2012 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 271, no 5, p. 481-489Article in journal (Refereed) Published
Abstract [en]

Objective: Chronic obstructive pulmonary disease (COPD) continues to be an important cause of morbidity, mortality and healthcare costs in the western world. Although smoking is an important trigger of COPD, other factors such as chronic inflammation and malnutrition are known to influence its development. Because coeliac disease (CD) is characterized both by dysregulated inflammation and malnutrition, the possibility of an association between CD and COPD was investigated.

Methods: Through biopsy data from all Swedish pathology departments, we identified 10990 individuals with CD who were biopsied between 1987 and 2008 (Marsh 3: villous atrophy). As controls, 54129 reference individuals matched for age, sex, county and calendar year of first biopsy were selected. Cox regression analysis was then performed to estimate hazard ratios (HRs) for having a diagnosis of COPD according to the Swedish Patient Register.

Results: During follow-up, 380 individuals with CD (3.5%) and 1391 (2.6%) controls had an incident diagnosis of COPD, which corresponds to an HR of 1.24 (95% CI: 1.10-1.38) and an excess risk of COPD of 79/100000 person-years in CD. The risk increase remained 5years after biopsy (HR=1.17; 95% CI: 1.00-1.37). Risk estimates did not change with adjustment for type 1 diabetes, thyroid disease, rheumatoid arthritis, country of birth or level of education. Men with CD were at a higher risk of COPD (HR=1.39; 95% CI: 1.18-1.62) than women with CD (HR=1.11; 95% CI: 0.94-1.30). Of note, CD was also associated with COPD before CD diagnosis (odds ratio=1.22; 95% CI: 1.02-1.46).

Conclusion: Patients with CD seem to be at a moderately increased risk of COPD both before and after CD diagnosis.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2012. Vol. 271, no 5, p. 481-489
Keywords [en]
chronic obstructive pulmonary disease, coeliac disease, cohort study, inflammation, lung disease
National Category
General Practice
Identifiers
URN: urn:nbn:se:oru:diva-55812DOI: 10.1111/j.1365-2796.2011.02448.xISI: 000303160600009PubMedID: 21880073Scopus ID: 2-s2.0-84860260889OAI: oai:DiVA.org:oru-55812DiVA, id: diva2:1074837
Funder
Swedish Society of MedicineSwedish Research Council, 522-2A09-195
Note

Funding Agencies:

Örebro University Hospital

Sven Jerring Foundation

Örebro Society of Medicine

Karolinska Institutet

Clas Groschinsky Foundation

Juhlin Foundation

Majblomman Foundation

Uppsala-Örebro Regional Research Council

Swedish Coeliac Society

Available from: 2017-02-16 Created: 2017-02-16 Last updated: 2018-01-13Bibliographically approved

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