Celiac disease linked to increased risk of premature death

April 07, 2020

People with celiac disease have increased risk of dying prematurely, despite increased awareness of the disease in recent years and better access to gluten-free food. This is according to a new study from Karolinska Institutet in Sweden and Columbia University in the U.S. published in the prestigious journal JAMA. Celiac disease was linked to increased risk of death from cardiovascular disease, cancer and respiratory disease.

Previous studies have demonstrated a modest but persistent increased risk of premature death in patients with celiac disease. However, in recent years, more people with milder disease have been diagnosed and gluten-free food is widely available. It has therefore been hypothesised that celiac disease may no longer be associated with an increased risk of death.

Using nationwide data from Sweden's pathology departments, linked to national healthcare registers, researchers at Karolinska Institutet and Columbia University examined almost 50,000 patients with celiac disease and their risk of death.

Compared with controls, overall mortality was increased by 21 percent in those with celiac disease. The relative increase in mortality risk was present in all age groups and greatest in those diagnosed in the age range of 18 to 39 years old.

"We have known that celiac disease can cause a number of long-term complications that can impact life expectancy, but this study examines an entire population in the most recent era, at a time when awareness of celiac disease and access to gluten-free food is widespread," says Benjamin Lebwohl, Director of Clinical Research at the Celiac Disease Center at Columbia University and first author of the study. "Despite this, we found that celiac disease is associated with long-term consequences."

Individuals with celiac disease were at increased risk of death from cardiovascular disease, cancer and respiratory disease. Compared with controls, the overall mortality risk was greatest in the first year after diagnosis but the risk increase persisted beyond 10 years after diagnosis. The increased risk was present also in patients diagnosed during recent years (2010-2017).

"Celiac disease is characterised by inflammation, which is generally bad for your health," says corresponding and last author, Jonas F Ludvigsson, senior paediatrician at Örebro University Hospital and professor of clinical epidemiology at the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet. "I am therefore not surprised that we found an increased mortality for a number of causes of death in individuals with celiac disease."

The fact that the relative risks were highest in the first year of follow-up can have several explanations, says Jonas F Ludvigsson.

"The intestinal inflammation is often most intense around diagnosis, and before a gluten-free diet has had an effect on mucosal healing. Another possible explanation is that the celiac diagnosis may have been made in patients who were very ill from other causes."

In separate analyses, the authors adjusted for socioeconomic status and comorbidity but the increased mortality risk for people with celiac disease remained.

The research was funded by the Swedish Research Council, the Celiac Disease Foundation and the Louis and Gloria Flanzer Philanthropic Trust. Jonas F Ludvigsson has previously coordinated another study that received funding from the pharmaceutical company Janssen. No other potential conflicts of interest are reported in the paper.
-end-
Publication: "Association Between Celiac Disease and Mortality Risk in a Swedish Population". Benjamin Lebwohl, Peter H.R. Green, Jonas Söderling, Bjorn Roelstraete, Jonas F Ludvigsson. Journal of the American Medical Association (JAMA), online 7 April 2020, doi: 10.1001/jama.2020.1943.

Karolinska Institutet

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.