oru.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • 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
Highly increased risk of celiac disease in individuals with Down syndrome: a nationwide case-control study
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
Clinical Epidemiology Unit and Department of Women’s and Children’s Health, Karolinska University Hospital and Institutet, Stockholm, Sweden.
Astrid Lindgren Children’s Hospital, Solna, Sweden.
Clinical Epidemiology Unit and Department of Women’s and Children’s Health, Karolinska University Hospital and Institutet, Stockholm, Sweden.
Show others and affiliations
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background & Aims: Several studies have indicated a high prevalence of celiac disease (CD) in individuals with Down syndrome (DS), but data from population based studies are lacking.

Methods: In this nationwide Swedish case-control study we examined the risk of CD in individuals with DS born between 1973 and 2008. Study participants consisted of two populations: 11,749 patients with biopsy-verified CD (villous atrophy [VA], equivalent to Marsh III) who were identified through histopathology reports from the 28 pathology departments in Sweden and 53,887 population-based controls matched for sex, age, calendar year of birth and county of residence. We used prospectively recorded data from Swedish health registers to identify individuals with DS. Odds ratios (ORs) were calculated using conditional logistic regression.

Results: Of the 11,749 individuals with CD, 165 had a diagnosis of DS (1.4%) as compared with 55/53,887 controls (0.1%), corresponding to an OR of 6.15 (95% confidence interval [CI] = 5.09-7.43). The association between DS and CD was not affected by maternal age at delivery, infant sex, or presence of type 1 diabetes mellitus in the child.

Conclusions: We found a six-fold increased risk of CD in individuals with DS. This study adds precision to the previously reported association between DS and CD and suggests that patients with DS should undergo screening for CD.

Keywords [en]
population register, risk assessment, screening
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-22742OAI: oai:DiVA.org:oru-22742DiVA, id: diva2:525255
Note

Karl Mårild is also affiliated to Astrid Lindgren Children’s Hospital, Solna, Sweden

J. F. Ludvigsson is also affiliated to Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden

Available from: 2012-05-07 Created: 2012-05-07 Last updated: 2017-10-17Bibliographically approved
In thesis
1. Risc factors and associated disorders of celiac disease
Open this publication in new window or tab >>Risc factors and associated disorders of celiac disease
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Celiac disease (CD) is an immune-mediated enteropathy induced by dietary gluten. CD is prevalent in some 1 % of the general population. In recent decades there has been a marked increase in CD prevalence that may be influenced by environmental risk factors.

Aims: The aim of this thesis was to examine possible risk factors for CD and to gain information on associated disorders of CD.

Methods: In study I we used regional cohort-data from ~11,000 children to examine the association between psychological stress in early life and subsequent CD. In studies II-IV we used nationwide histopathology data to identify individuals with CD (i.e. villous atrophy). In study II we linked data on ~29,000 CD patients to the National patient register to examine the risk of hospital admission for influenza. In studies III-IV we linked data on ~11,000 CD patients to several Swedish registries, including the Medical birth register, to examine neonatal risk factors in CD (study III) and the risk of CD in patients with Down syndrome (study IV).

Results: Psychological stress in the first years of life was not associated with subsequent CD. We found a two-fold increased risk of hospital admission for influenza in patients with CD (95 % confidence interval [CI] = 1.6-2.7).While elective cesarean delivery was associated with an increased risk of later CD (adjusted Odds Ratio [OR] = 1.15; 95 % CI = 1.04-1.26), emergency cesarean delivery was not (adjusted OR = 1.02; 95 % CI = 0.92-1.13). Finally, in study IV we found a six-fold increased risk of CD in children with Down syndrome (95 % CI = 5.09-7.43).

Conclusion: This thesis supports the hypothesis that certain environmental risk factors, such as mode of delivery, but possibly not early psychological stress, influence the risk of CD. The increased risk of hospital admission for influenza indicate that individuals with CD may benefit from influenza immunization. The highly increased risk of CD in Down syndrome supports CD screening in Down syndrome patients.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2012. p. 102
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 68
Keywords
Celiac disease, cohort study, Down syndrome, influenza, pediatrics, population-based, pregnancy outcome, psychological stress, registry
National Category
Medical and Health Sciences Gastroenterology and Hepatology
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-22136 (URN)978-91-7668-865-6 (ISBN)
Public defence
2012-05-25, Wilandersalen, Universitetssjukhuset i Örebro, Örebro, 13:30 (Swedish)
Opponent
Supervisors
Available from: 2012-03-16 Created: 2012-03-16 Last updated: 2017-10-17Bibliographically approved

Open Access in DiVA

No full text in DiVA

Authority records BETA

Mårild, KarlLudvigsson, Jonas F.

Search in DiVA

By author/editor
Mårild, KarlLudvigsson, Jonas F.
By organisation
School of Health and Medical Sciences, Örebro University, Sweden
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

urn-nbn

Altmetric score

urn-nbn
Total: 325 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • 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