Long-term Consequences of Undiagnosed Celiac Seropositivity

Diagnosed celiac disease (CD) is associated with lymphoproliferative malignancy and gastrointestinal cancer, but little is known about the long-term consequences of undiagnosed CD. We aimed to investigate long-term consequences of undiagnosed CD for mortality and incidence of cancer and other chroni...

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Vydané v:The American journal of gastroenterology Ročník 115; číslo 10; s. 1681 - 1688
Hlavní autori: Kårhus, Line Lund, Skaaby, Tea, Petersen, Janne, Madsen, Anja Lykke, Thuesen, Betina Heinsbæk, Schwarz, Peter, Rumessen, Jüri J., Linneberg, Allan
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States Wolters Kluwer 01.10.2020
Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
Predmet:
Adolescent
Adult
Aged
Antibodies
Antibodies - immunology
Asymptomatic
Autoantibodies - immunology
Autoimmune diseases
Biobanks
Biological Specimen Banks
Biomarkers
Biopsy
Breast cancer
Breast Neoplasms - epidemiology
Cancer
Cardiovascular disease
Cardiovascular Diseases - epidemiology
Celiac disease
Celiac Disease - epidemiology
Celiac Disease - immunology
Denmark - epidemiology
Emigration
Female
Gastroenterology
Gastrointestinal Neoplasms - epidemiology
Gliadin - immunology
Gluten
GTP-Binding Proteins - immunology
Head & neck cancer
Head and Neck Neoplasms - epidemiology
Humans
Immunoglobulin A - immunology
Immunoglobulin G - immunology
Immunoglobulins
Incidence
Lymphoma
Male
Middle Aged
Mortality
Neoplasms - epidemiology
Peptides
Population
Prevalence
Proportional Hazards Models
Risk Factors
Transglutaminases - immunology
Undiagnosed Diseases - epidemiology
Uterine cancer
Uterine Neoplasms - epidemiology
Young Adult
Denmark
ISSN:0002-9270, 1572-0241, 1572-0241
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Shrnutí:Diagnosed celiac disease (CD) is associated with lymphoproliferative malignancy and gastrointestinal cancer, but little is known about the long-term consequences of undiagnosed CD. We aimed to investigate long-term consequences of undiagnosed CD for mortality and incidence of cancer and other chronic diseases. We screened biobank serum samples for immunoglobulin (Ig) A and IgG tissue transglutaminase (TTG) and IgG deamidated gliadin peptide in a study of 8 population-based cohort studies comprising 16,776 participants examined during 1976-2012 and followed with >99% complete follow-up in Danish nationwide registries until December 31, 2017, regarding vital status and incidence of diseases. Undiagnosed CD was defined as antibody positivity (IgA-TTG or IgG-TTG ≥ 7 U/mL and/or IgG deamidated gliadin peptide ≥ 10 U/mL) in individuals without a diagnosis of CD recorded in the National Patient Register. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated by Cox regression analyses with age as the underlying time scale. The prevalence of undiagnosed CD was 1.0% with no statistically significant increase over time. Undiagnosed CD was associated with increased risk of cancer overall (HR, 1.57; 95% CI, 1.16-2.11), gastrointestinal cancer (HR, 2.33; 95% CI, 1.35-4.04), cancer of the uterus (HR, 3.95; 95% CI, 1.46-10.69), breast cancer (HR, 1.98; 95% CI, 1.02-3.82), head and neck cancer (HR, 3.12; 95% CI, 1.15-8.43), and cardiovascular disease (HR, 1.37; 95% CI, 1.01-1.85). We found no statistically significant association between undiagnosed CD and mortality (HR, 1.19; 95% CI, 0.87-1.61). Undiagnosed CD was associated with increased risk of cardiovascular disease and cancer suggesting that untreated CD has serious long-term health consequences not only affecting the gastrointestinal tract (see Visual Abstract, Supplementary Digital Content, http://links.lww.com/AJG/B566).
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0002-9270
1572-0241
1572-0241
DOI:10.14309/ajg.0000000000000737