Cardiovascular disease in patients with coeliac disease: A systematic review and meta-analysis

详细信息    查看全文

• 作者：Louise Emilsson^a ; ^b ; ^{lojsankik@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Benjamin Lebwohl^c ; ^d ; Johan Sundströ ; m^e ; Jonas F. Ludvigsson^d ; ^f
• 关键词：Celiac ; Coeliac ; Cardiovascular disease ; Meta-analysis
• 刊名：Digestive and Liver Disease
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：47
• 期：10
• 页码：847-852
• 全文大小：993 K

文摘

Coeliac disease has been associated with an increased risk of cardiovascular disease in some studies, whereas other studies have shown no association. We performed a systematic review and meta-analysis of cardiovascular disease in celiac disease.

Methods

Pubmed, Cinahl, EMBASE and Medline via Ovid were searched for relevant articles published until January 5, 2015. English-language articles on studies with more than 20 patients were included, and were quality rated using the GRADE risk of bias tool. We used random-effects models and assessed heterogeneity using the I² statistic.

Results

Ten studies were relevant, reporting the risk of myocardial infarction, cardiovascular death and stroke in 33,128/32,903/32,466 coeliac disease patients respectively. Only one study examined celiac disease and a composite measure of cardiovascular disease and this study found a hazard ratio of 1.10 (95%CI 1.03–1.28). In a meta-analysis, we observed an increased risk of stroke (OR 1.11; 95%CI 1.02–1.20). The risks of myocardial infarction (OR 1.12; 95%CI 0.83–1.40) and cardiovascular death (OR 1.12; 95%CI 0.96–1.29) were similar but were estimated with less certainty. Heterogeneity was low for all outcomes except for myocardial infarction where it was moderate.

Conclusion

Coeliac disease was associated with a modestly increased risk of cardiovascular disease, but the evidence base is limited.