Study Reveals Increased Risk of Death from Celiac Disease
Celiac disease increases the risk of death to those who have the inherited intestinal disorder. Depending on the severity of the disease, the increased risk can range from 35% to 72% according to a new population-based study.
Jonas F. Ludvigsson, MD, PhD, of Örebro University Hospital in Sweden, and colleagues reported the findings of their population-based study in the Sept. 16 Journal of the American Medical Association. The researchers looked at histopathology data reports from intestinal tissue biopsies collected from 46,121 Swedish patients from the years 1969 to 2008.
The researchers found 29,096 of those patients had celiac disease, while 13,306 had inflammation of the small intestine and 3,719 had latent celiac disease, in which patients tested positive for blood antibodies used as markers for celiac disease but had no signs of intestinal inflammation or damage.
To estimate the morality rates, the researchers compared the patient data to records of the Swedish Total Population Register. There were 3,049 deaths among those patients with celiac disease, 2,967 deaths for those with inflammation, and 183 deaths for patients with latent celiac disease.
The researchers found that those with less severe degrees of celiac disease are at higher risk of death than the others. Patients with mild inflammation of the intestine were found to have an increased risk of mortality of 75% and those with latent celiac disease (gluten sensitivity) were found to have an increased risk of mortality of 35%.
Overall, the researchers found that patients diagnosed with celiac disease had a 30% greater risk of death at a median follow-up of 8.8 years. The main causes of death for celiac patients were cardiovascular disease and cancer.
To keep it in perspective, the absolute mortality risk was modest. The increased mortality was 2.9 deaths per 1,000 person-years in celiac disease and 10.8 and 1.7 deaths per 1,000 person-years in inflammation and latent celiac disease, respectively.
Celiac disease is an immune-mediated disorder triggered by ingesting glutens, the storage proteins of wheat, rye and barley. The disease is estimated to affect about 1% percent of people living in Western countries. It impairs digestion of nutrients through the small intestine, resulting in frequent diarrhea and weight loss.
The exact cause of celiac disease is unknown. The intestines contain projections (called villi) that absorb nutrients. In undiagnosed or untreated celiac disease, these villi become flattened. This affects the ability to absorb nutrients properly.
The disease can develop at any point in life, from infancy to late adulthood. The disorder is most common in Caucasians and those of European ancestry. Women are affected more commonly than men.
Symptoms of celiac disease can vary significantly from person to person. This is part of the reason the diagnosis is frequently delayed. Symptoms may include abdominal pain, bloating, constipation, diarrhea, lactose intolerance, foul smelling stools, and unexplained weight lose. For more information, check out the Celiac Sprue Association.
Ludvigsson J, et al "Small-intestinal histopathology and mortality risk in celiac disease" JAMA 2009; 302: 1171-78.
National Institute of Health
Celiac Sprue Association