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Association of Celiac Disease and Inflammatory Bowel Disease: A Nationwide Register-Based Cohort Study.
- Source :
-
American Journal of Gastroenterology (Lippincott Williams & Wilkins) . Sep2022, Vol. 117 Issue 9, p1471-1481. 11p. - Publication Year :
- 2022
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Abstract
- INTRODUCTION: To determine the risk of inflammatory bowel disease (IBD) in patients with celiac disease (CeD) (and vice versa) compared with general-population comparators. METHODS: Using Swedish histopathology and healthcare register data, we identified 48,551 patients with CeD and 83,529 with IBD diagnosed in 1969–2016. Each patient was compared with age- and sex-matched general-population comparators (CeD: n = 240,136; IBD: n = 408,195). Cox regression estimated hazard ratios (HRs) for IBD in patients with CeD and vice versa. Our main analyses were limited to events beyond the first year of follow-up to reduce potential surveillance bias. RESULTS: During follow-up, 784 (1.6%) patients with CeD were diagnosed with IBD compared with 1,015 (0.4%) matched comparators. In patients with CeD, the HR for IBD was 3.91 (95% confidence interval [CI] 3.56–4.31), with largely similar HRs for Crohn's disease (4.36; 3.72–5.11) and ulcerative colitis (3.40; 3.00–3.85). During follow-up, 644 (0.8%) patients with IBD and 597 (0.1%) comparators were diagnosed with CeD. The HR for CeD in patients with IBD was 5.49 (95% CI 4.90–6.16), with the highest risk estimates seen in ulcerative colitis (HR = 6.99; 6.07–8.05), and the HR for Crohn's disease was 3.31 (2.69–4.06). In patients with CeD and IBD, the diagnostic interval was usually <1 year; however, HRs of 3–4 were seen even after 10 years of follow-up. During 20 years of follow-up, 2.5% of patients with CeD developed incident IBD, and 1.3% of patients with IBD developed CeD. DISCUSSION: The bidirectional association between CeD diagnosis and IBD warrants attention in the initial assessment and follow-up of these conditions. Their co-occurrence, independent of temporal sequence, suggests shared etiology. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00029270
- Volume :
- 117
- Issue :
- 9
- Database :
- Academic Search Index
- Journal :
- American Journal of Gastroenterology (Lippincott Williams & Wilkins)
- Publication Type :
- Academic Journal
- Accession number :
- 158803949
- Full Text :
- https://doi.org/10.14309/ajg.0000000000001834