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Risk of diabetes and cardiovascular disease in patients with primary sclerosing cholangitis
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0003-1024-5602
Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; University College London, London, UK .ORCID iD: 0000-0001-6328-5494
Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; Golestan University of Medical Sciences, Gorgan, Iran.
2013 (English)In: Journal of Hepatology, ISSN 0168-8278, E-ISSN 1600-0641, Vol. 60, no 4, p. 802-808Article in journal (Refereed) Published
Abstract [en]

Background & Aims: Primary sclerosing cholangitis (PSC) is associated with increased mortality. Cardiovascular disease is a leading cause of death in the Western world. We examined the risk of cardiovascular disease and diabetes (type 1 and type 2) in patients with PSC and their first-degree relatives.

Methods: This prospective multicentre cohort study included 678 individuals with PSC diagnosed between 1970 and 2004, and 6347 non-PSC reference individuals matched for age, and sex. Through linkage of the Swedish Multigeneration Register we identified 3139 first-degree relatives to PSC patients and 30,953 first-degree relatives to the matched comparison cohort. We retrieved data on cardiovascular disease and type 1 and type 2 diabetes (T1D and T2D) from the National Patient Register, and then examined the association with PSC or having a family history of PSC using Poisson regression.

Results: During 125,127 person-years of follow-up, 203 individuals with PSC had a diagnosis of cardiovascular disease. This corresponded to a 3.34-fold increased relative risk (RR) of cardiovascular disease in individuals with PSC (95% CI = 2.86-3.91). The highest risk estimates were seen for diseases of the arteries, veins, and lymphatic vessels while the RR was neutral for ischemic heart disease (0.90) or only slightly elevated for cerebrovascular disease (1.74). Meanwhile, PSC first-degree relatives were at no increased risk of cardiovascular disease (RR = 0.87; 95% CI = 0.80-0.95). Individuals with PSC (RR = 7.95; 95% CI = 4.82-13.12), and to some extent also their first-degree relatives (RR = 1.73; 95% CI = 1.19-2.52) were at increased risk of T1D. Also for T2D were the RR is higher in individuals with PSC (RR = 2.54; 95% CI = 1.56-4.13) than in PSC first-degree relatives (RR = 0.81; 95% CI = 0.65-1.02).

Conclusions: PSC was associated with T1D, T2D, and non-ischemic cardiovascular disease. In contrast, first-degree relatives to PSC patients were only at a moderately increased risk of T1D, and at no increased risk of either cardiovascular disease or T2D.

Place, publisher, year, edition, pages
Elsevier, 2013. Vol. 60, no 4, p. 802-808
Keywords [en]
Bile duct diseases; Diabetes; Heart; Liver; Primary sclerosing cholangitis
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-32985DOI: 10.1016/j.jhep.2013.11.017ISI: 000333106600017PubMedID: 24291242Scopus ID: 2-s2.0-84896389434OAI: oai:DiVA.org:oru-32985DiVA, id: diva2:685174
Note

Funding Agencies:

Swedish Society of Medicine

Swedish Research Council - Medicine

Available from: 2014-01-09 Created: 2014-01-09 Last updated: 2018-07-22Bibliographically approved

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Ludvigsson, Jonas F.Montgomery, Scott M.

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School of Health and Medical Sciences, Örebro University, SwedenÖrebro University Hospital
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