oru.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Celiac disease and risk of liver disease: a general population-based study
Örebro University, School of Health and Medical Sciences.
Karolinska Institutet.
Show others and affiliations
2007 (English)In: Clinical Gastroenterology and Hepatology, ISSN 1542-3565, E-ISSN 1542-7714, Vol. 5, no 1, p. 63-69Article in journal (Refereed) Published
Abstract [en]

Background & aims: Celiac disease (CD) is an important cause of hypertransaminasemia. CD may also be associated with severe forms of liver disease. We investigated the risk of liver disease in 13,818 patients with CD (1964-2003) and 66,584 age- and sex-matched reference individuals from a general population cohort.Methods: We used Cox regression to estimate hazard ratios (HRs) for later liver disease and conditional logistic regression to estimate the risk of CD in individuals with liver disease prior to study entry.Results: CD was associated with an increased risk of acute hepatitis (HR = 5.21; 95% CI = 1.88-14.40; P = .001), chronic hepatitis (HR = 5.84; 95% CI = 2.89-11.79; P < .001), primary sclerosing cholangitis (PSC)(HR = 4.46; 95% CI = 2.50-7.98; P < .001), fatty liver (HR = 6.06; 95% CI = 1.35-27.16; P = .018), liver failure (HR = 3.30; 95% CI = 2.22-4.88; P < .001), liver cirrhosis or liver fibrosis (HR = 2.23; 95% CI = 1.34-3.72; P < .001) and primary biliary cirrhosis (HR = 10.16; 95% CI = 2.61-39.49; P < .001). There was no increased risk of liver transplantation (HR = 1.07; 95% CI = 0.12-9.62; P = .954). Adjustment for socioeconomic index or diabetes mellitus had no notable effect on the risk estimates.Prior liver disease was associated with a statistically significant 4-6 fold increased risk of later CD.Conclusion: This study suggests that individuals with CD are at increased risk of both prior and subsequent liver disease.

Place, publisher, year, edition, pages
Amsterdam: Elsevier , 2007. Vol. 5, no 1, p. 63-69
Keyword [en]
autoimmune; celiac; cirrhosis; cohort study; liver and primary sclerosing cholangitis
National Category
Gastroenterology and Hepatology Pediatrics Medical and Health Sciences
Research subject
Pediatrics
Identifiers
URN: urn:nbn:se:oru:diva-5212DOI: 10.1016/j.cgh.2006.09.034OAI: oai:DiVA.org:oru-5212DiVA, id: diva2:158203
Note
Part of thesis: http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-5223Available from: 2009-01-30 Created: 2009-01-30 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Associated disorders in celiac disease
Open this publication in new window or tab >>Associated disorders in celiac disease
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Celiac disease (CD) is an autoimmune disorder that affects genetically susceptible individuals and is induced by dietary gluten. Treatment consists of a lifelong gluten-free diet. CD is common and affects about 1% of the general population. The classic symptoms include diarrhea and malabsorption, but many patients have only mild symptoms or no symptoms at all. The proportion of individuals presenting with atypical symptoms or discovered only when investigating an associated condition of CD is increasing.

Aims: The aim of this thesis was to investigate the risk of possible associated disorders through Swedish population-based registers. The objective was to gain more information on the consequences of having CD and to identify high risk groups where screening may be considered.

Materials and methods: We used the Swedish hospital discharge register to examine the risk of liver disease, autoimmune heart disease, Addison’s disease and thyroid disorders in a cohort of about 14,000 individuals with CD and an age and sex matched reference population of 70,000 individuals. In the last study we used all regional pathology registers and the cancer registry to examine the risk of hematopoietic cancer, including lymphoma in three different cohorts: I) 28,810 individuals with CD; II) 12,681 individuals with small intestinal mucosal inflammation but without villous atrophy; and III) 3552 individuals with latent CD (a positive serology test for CD with a normal small intestinal biopsy).

Results: CD is statistically significantly associated with an increased risk of liver disease, Addison’s disease, thyroid disease and lymphoma. We also found an increased risk of lymphoma in individuals with small intestinal mucosal inflammation. There was no statistically significant association between autoimmune heart disease or leukemia and CD. Latent CD was not associated with any hematopoietic cancers.

Conclusion: This thesis found a positive association between CD and a number of autoimmune and inflammatory disorders. Clinicians need to have a high awareness of this association and to test for these conditions when symptoms appear.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2009. p. 83
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 27
Keyword
Addison, autoimmune, biopsy, celiac, child, cohort study, cancer, heart, liver, lymphoma, thyroid
National Category
Pediatrics Medical and Health Sciences
Research subject
Pediatrics; Epidemiology; Medicine
Identifiers
urn:nbn:se:oru:diva-5223 (URN)978-91-7668-649-2 (ISBN)
Public defence
2009-02-27, Wilandersalen, Universitetssjukhuset Örebro, Örebro, 10:00 (English)
Opponent
Supervisors
Available from: 2009-02-06 Created: 2009-01-30 Last updated: 2017-10-18Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full texthttp://www.ncbi.nlm.nih.gov/pubmed/17161656?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

Authority records BETA

Elfström, PeterMontgomery, Scott M.

Search in DiVA

By author/editor
Elfström, PeterMontgomery, Scott M.
By organisation
School of Health and Medical Sciences
In the same journal
Clinical Gastroenterology and Hepatology
Gastroenterology and HepatologyPediatricsMedical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 350 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf