Nationwide population-based cohort study of celiac disease and risk of Ehlers-Danlos syndrome and joint hypermobility syndrome

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• 作者：Monika Laszkowska^a ; ¹ ; Abhik Roy^a ; ¹ ; Benjamin Lebwohl^a ; ^b ; Peter H.R. Green^a ; Helé ; ne E.K. Sundelin^c ; Jonas F. Ludvigsson^b ; ^d ; ^e ; ^{jonasludvigsson@yahoo.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Cohort study ; Epidemiology ; Gluten ; Hypermobility syndrome
• 刊名：Digestive and Liver Disease
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：48
• 期：9
• 页码：1030-1034
• 全文大小：423 K

文摘

Patients with celiac disease (CD) often have articular complaints, and small prior studies suggest an association with Ehlers-Danlos syndrome (EDS)/joint hypermobility syndrome (JHS).

Aims

This study examines the risks of EDS/JHS in patients with CD.

Methods

This cohort study compared all individuals in Sweden diagnosed with CD based on small intestinal biopsy between 1969–2008 (n = 28,631) to 139,832 matched reference individuals, and to a second reference group undergoing biopsy without having CD (n = 16,104). Rates of EDS/JHS were determined based on diagnostic codes in the Swedish Patient Register. Hazard ratios (HRs) for EDS/JHS were estimated through Cox regression.

Results

There are 45 and 148 cases of EDS/JHS in patients with CD and reference individuals, respectively. This corresponds to a 49% increased risk of EDS/JHS in CD (95%CI = 1.07–2.07). The HR for EDS was 2.43 (95%CI = 1.20–4.91) and for JHS 1.34 (95%CI = 0.93–1.95). Compared to reference individuals undergoing intestinal biopsy, CD was not a risk factor for EDS/JHS. A stronger association was seen in patients initially diagnosed with EDS/JHS and subsequently diagnosed with CD (odds ratio = 2.29; 95%CI = 1.21–4.34).

Conclusions

Individuals with CD have higher risk of EDS/JHS than the general population, which may be due to surveillance bias or factors intrinsic to celiac development.