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  • Jefferson Adams
    Jefferson Adams
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    A Nationwide Study of the Association Between Celiac Disease and the Risk of Autistic Spectrum Disorders

    Celiac.com 10/15/2013 - Most case reports suggest an association between autistic spectrum disorders (ASDs) and celiac disease (celiac disease) or positive celiac disease serologic test results, but larger studies are contradictory.

    http://archpsyc.jamanetwork.com/article.aspx?articleid=1743008A team of researchers recently set out to examine the association between ASDs and celiac disease according to small intestinal histopathologic findings.

    The research team included Jonas F. Ludvigsson; Abraham Reichenberg; Christina M. Hultman; and Joseph A. Murray. They are variously affiliated with the Department of Medicine, Clinical Epidemiology Unit, and the Department of Medical Epidemiology and Biostatistics at the Karolinska Institutet in Stockholm, Sweden, with the Department of Pediatrics at Orebro University Hospital, Orebro University in Orebro, Sweden, with the Division of Gastroenterology and Hepatology of the Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, with the Department of Psychosis Studies at the Institute of Psychiatry at King’s College in London, United Kingdom, and with the Department of Psychiatry at the Mount Sinai School of Medicine in New York, New York.

    For their nationwide case-control study, the researchers used 28 Swedish biopsy registers to gather data on approximately 26,995 individuals with celiac disease, which they defined as the presence of villous atrophy, Marsh stage 3.

    They found 12,304 patients with inflammation (Marsh stages 1-2), 3719 patients with normal mucosa (Marsh stage 0), but positive celiac results for IgA/IgG gliadin, endomysium, or tissue transglutaminase. They then compared these results against and results for 213,208 age- and sex-matched control subjects. The team used conditional logistic regression to estimate odds ratios (ORs) for prior ASD diagnosis according to the Swedish National Patient Register and then conducted a second analysis, using Cox proportional hazards regression to estimate hazard ratios (HRs) for future ASDs in individuals undergoing small intestinal biopsy.

    They found that previous ASD was not associated with celiac disease (OR, 0.93; 95% CI, 0.51-1.68) or inflammation (OR 1.03; 95% CI, 0.40-2.64). However, they did finds that previous ASD was associated with a sharp higher risk of having normal mucosa but positive serologic test result for celiac disease (OR, 4.57; 95% CI, 1.58-13.22).

    Once the team restricted the data to individuals without no diagnosis for ASD at the time of biopsy, they found that celiac disease (HR, 1.39; 95% CI, 1.13-1.71) and inflammation (HR, 2.01; 95% CI, 1.29-3.13) were both connected with slightly higher risks of later ASDs, compared against the HR of 3.09 (95% CI, 1.99-4.80) for later ASDs in individuals with normal mucosa but positive celiac disease serologic test results.

    Even though this study showed no connection between previous ASD and celiac disease or inflammation, it did show that individuals with normal mucosa, but positive blood screens for celiac disease, have a much higher risk of ASD.

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    Thank you for investigating this increasing and awful difficulty for children and adults with such eminent research. I personally have always believed there was a link between gluten-free/casein and the Autism spectrum. Please continue to do your utmost to help.

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  • About Me

    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, and science. He previously served as Health News Examiner for Examiner.com, and provided health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

  • Related Articles

    Jefferson Adams
    Celiac.com 05/08/2007 - A recent news release by the American Academy of Neurology claims that results of a recent Iranian study find no link between autism in children and the development of celiac disease. The study was conducted by a team of researchers led by Dr. Samra Vazirian of Tehran University of Medical Sciences.
    The researchers compared blood samples from 34 children with autism and 34 children without autism. All blood samples were tested for antibodies used to detect celiac disease: anti-gliadin and anti-endomysial antibodies. Six children tested positive for these antibodies (four with autism, two without autism). These children were given intestinal biopsies to confirm the serological tests. The biopsies on all six children were negative for celiac disease.
    From this, researchers concluded that children with celiac disease were no more likely to develop celiac disease than children without autism. According to Dr. Samra Vazirian, the gluten intolerance suffered by people with celiac disease might have no connection to autism, but also indicates that further research into the matter will be of benefit.
    American Academy of Neurology, news release, May 1, 2007.
    **Authors note: Given the small sample of subjects in this study, and given the clinical and anecdotal evidence for autistic children responding favorably to a gluten-free diet, coupled with the difficulty of conducting a comprehensive double-blind study involving clinical responses to a gluten free diet in autistic children versus their non-autistic counterparts, the results of this test should be treated with considerable scrutiny, if not outright skepticism. It will be interesting to find out whether or not the researchers used Marsh criteria in their assessment of the biopsies. Given the fact that double the number of autistic children had celiac disease positive serology we must conclude that, at the very least, autistic children have double the rate of gluten sensitivity than their non-autistic counterparts.
    health writer who lives in San Francisco and is a frequent author of articles for Celiac.com.

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    Okay, thanks. Re: MTHFR - I don't really know yet... I only started reading about it yesterday and it is pretty overwhelming. But it does seem to be common advice that if you have a close relative with it you should be tested, and I guess having 2 copies of the "C" variant, as my sister has, is the "worst" variety of it.  It came to light for her when she was going through infertility and miscarriages.  They discovered that her homocysteine was high, which led to the MTHFR testing. So that is one thing I know I would then want to proceed to do, if I do have it - get my homocysteine tested. My dad died of early-onset Alzheimer's, and apparently there is a link between high homocysteine as well as the MTHFR mutation and Alzheimer's. It also seems like it would be worth knowing if I have it since it could be the cause of my lower levels of B12. And I guess maybe I would need to start taking methyl-folate? I mean, to answer your question, I am not entirely sure what I will do if I do have it.   Probably read a lot more about it... and take supplements like methyl-folate if I really think I need to.  Check my homocysteine & control that if I need to, hopefully to lower my risk of Alzeheimer's.  It seems like a frustrating area because there appear to be limited official medical websites that really even talk much about it (so far).  I have found one article on the NIH that focuses on the link with high homocysteine. I already eat a very healthy diet.  Whole grains, lots of fruit & veg, mostly organic.  I am a vegetarian except for very rare seafood. I avoid processed food and, above all, foods with added sugar...  To me, sugar is by far the worst culprit in the SAD.  I think RA has been ruled out by my 2 negative Rheumatoid Factor tests (one done several years ago, one just this year at my physical).  Also, the way this started in my elbows, and was really only there for years, is just... weird... and definitely doesn't really fit with arthritis.  And there is no swelling to speak of, just mild pain - sometimes aching, sometimes burning, sometimes sharp...  It may or may not fit with any systemic diagnosis versus a mechanical one, but nowadays I do also have pain in my hands, feet, and knees.  So then I think, well maybe it is/was something systemic, but it was worse in my elbows for some mechanical reason but now has progressed elsewhere.  I thought Crohn's was just digestive?  (Of course, many people think that of celiac.)  So I haven't really investigated that one much. My ANA was retested and is back down to "negative," so I think that pretty much rules out lupus.  I believe fibromyalgia is still on the table. Anyhow....  Your point is nonetheless taken.  I do want to rule out celiac and go from there.  At this point I'd sure love to find out it is something I could control through my diet!
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