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Celiac.com 01/13/2020 - Numerous genetic studies have identified many highly significant SNPs related to hundreds of diseases or medical conditions. However, very little is known about how GWAS-identified SNPs or combinations of SNP biomarkers can predict the risk for certain diseases, such as celiac disease. A team of researchers recently set out to assess the extent to which GWAS-identified SNPs or combinations of SNP biomarkers can predict disease risk. The research team included Jonas Patron, Arnau Serra-Cayuela, Beomsoo Han, Carin Li, and David Scott Wishart. They are variously affiliated with the Department of Biological Sciences, University of Alberta, Edmonton, Canada, and the Department of Computing Science, University of Alberta, Edmonton, Canada Currently, one of the most common ways researchers gauge the performance of any given predictive biomarker is to calculate the area under the receiver-operator characteristic curve, aka AUROC. To create ROC curves and calculate the AUROC using summary-level GWAS data, the team has developed an R package called G-WIZ. The team made initial tests of G-WIZ using AUROC values gleaned from patient-level SNP data, as well as reported AUROC numbers. The research team found that G-WIZ predicts the AUROC with greater than 97% accuracy. Next, the team used summary data from GWAS Central to determine the ROC curves and AUROC values for 569 different GWA studies spanning 219 different conditions. Armed with this data, the team found a number of GWA studies with SNP-derived risk predictors that have very high AUROCs, above 0.75, while the average GWA study produces a multi-SNP risk predictor with an AUROC of just 0.55. Detailed AUROC comparisons reveal that most SNP-derived risk predictions are not as good as clinically based disease risk predictors. Being able to accurately predict risk for certain diseases will help clinicians to better identify patients for potential testing and diagnosis, so knowing the best predictive methods is highly useful information. The team’s data, including ROC curves, AUROCs, explained heritability, have been placed in a public database called GWAS-ROCS. Interested parties may download the G-WIZ code for free at github.com. Read more at PLOSONE.com -
Celiac.com 12/26/2019 - Earlier studies have suggested a relationship between infection, associated antibiotic exposure, and the risk of celiac disease. However, there hasn't been a comprehensive evaluation of those studies that might help to deliver a clear answer. To address this, a team of researchers recently conducted a meta-analysis to investigate the relationship between infection, associated antibiotic exposure, and celiac disease risk. They began looking for relevant studies by searching the PubMed, Embase, and Cochrane databases for articles published through April 2019. They used random effects models to determine overall pooled estimates and 95% confidence intervals (CIs). Their meta-analysis contained 19 observational studies, including 15 on infection and six on antibiotic exposure. They found that any infection was associated with an increased risk of celiac disease later in life. The heterogeneity among studies was high enough to put the I2 at 94%. An analysis of subgroups indicates that celiac risk is independent of infection type, timing of exposure, or site of infection. Antibiotic exposure was also associated with new celiac disease cases. These results provide strong evidence that early infection and/or antibiotic exposure increase the odds of developing celiac disease, and suggest that disruption of intestinal immune processes or gut microbiota may play a role in celiac disease development. These findings could eventually influence clinical treatment and help to prevent celiac disease. Certainly, the rise of antibiotic use to treat infections mirrors the rise in cases of celiac disease over the last six or seven of decades. However, further study is needed to fully eliminate non-causal explanations for these connections. That is, they haven't fully discounted the possibility that there is another cause for the connection. Stay tuned for more developments on this and related stories. Read more at: wiley.com The research team included Hai-yin Jiang, Xue Zhang, Yuan-yue Zhou, Chun-min Jiang, and Yu-dan Shi. They are variously affiliated with the Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, the Department of Child Psychiatry, Hangzhou Seventh People’s Hospital, Department of Pediatrics, The Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou and Department of Chinese Internal Medicine, Taizhou First People’s Hospital, Taizhou, China. -
Woman Discovers Her Celiac Disease with 23andMe Gene Test
Jefferson Adams posted an article in Additional Concerns
Celiac.com 10/22/2019 - Many people use DNA testing services, like 23andMe, to check on their ancestry. However, such sites can also be helpful in revealing genetic risk for certain diseases. Take the case of Carol Mayes, a West Virginia woman, whose 23andMe test results led to the discovery of her celiac disease. Once tested, the simple saliva sample led Mayes to discover that she had an elevated risk for celiac disease. “I always had migraines that never went away and my dad said, ‘Why don’t you do Tylenol?’ I said, ‘Tylenol doesn’t work for me,'” Mayes explained. “I always try to donate blood and each time I can never do it because my iron was always low." When she put the DNA results together with her medical history of migraines, and low iron in her blood, Mayes pressed her doctor for a celiac blood test. "I asked my doctor, ‘Can you test me for Celiac disease?’ And I came back with my test results and I was positive for celiac disease.” Services like 23andMe can reveal genetic risk factors for many diseases, including Alzheimer’s, Parkinson’s and certain types of cancer, though they do not typically diagnose any health conditions. The IRS recently permitted tax deductions for DNA tests, like 23andMe, that are used for medical purposes. -
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Celiac.com 10/07/2019 - Researchers know that people with autoimmune disorders have a higher risk of developing celiac disease, but there's no clear data on the risk of autoimmune disorders in treated patients with celiac disease. To find out if treated celiac patients on a gluten-free diet had an elevated risk of developing autoimmune disorders, a team of researchers recently set out to assess the incidence of autoimmune disorders in treated celiac disease patients. The research team included Muhammad R Khan, Shilpa S Nellikkal, Ahmed Barazi, Joseph J Larson, Joseph A. Murray, Imad Absah. They are variously affiliated with the Division of Pediatric Gastroenterology and Hepatology; the Division of Biomedical Statistics and Informatics; and the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN. The team used the Rochester Epidemiology Project to search medical records at Mayo Clinic and Olmsted Medical Center from January 1997 to December 2015 for patients with clinical celiac disease. For each celiac patient, the team identified two age and sex-matched control subjects. They calculated rates of diagnosed autoimmune disorder five years after index date using Kaplan-Meier analysis for both celiac cases and control subjects. They then compared the results using the log-rank test. They found a total of 249 celiac patients, who were following a gluten-free diet during the study period, and matched them with 498 control subjects. A total of 85 celiac patients and 170 control subjects were boys. Five years after the index date, 5.0% of patients with celiac disease and 1.3% of controls had a new autoimmune disorder diagnosis. Treated celiac patients face an elevated risk of developing autoimmune disorders. The risk of a new autoimmune disorder is higher in children, especially when >1 autoimmune disorder diagnosis exists. For celiac patients with prior autoimmune disorder, the cumulative risk of a new or additional autoimmune disorder was much higher compared with control subjects. Also, children faced a significantly higher risk of autoimmune disorder development compared with adults. Read more in the Journal of Pediatric Gastroenterology and Nutrition: October 2019 - Volume 69 -
Celiac.com 09/30/2019 - We know from recent studies that high gluten intake in infancy can raise risk for celiac disease, and we know that the amount of gluten eaten by infants at 18 months heavily influences their risk of developing type 1 diabetes later in life. An earlier study conducted in Denmark suggested that a high maternal gluten consumption during pregnancy increased the risk of type 1 diabetes in the child. Until now, researchers have not looked at levels of gluten intake by both the mother during pregnancy and the child in early life, and how that influences risk of developing type 1 diabetes in childhood. Now, a new study shows that every 10 grams of extra gluten eaten at age 18 months is associated with a 46% increased risk of developing type 1 diabetes. The researchers recently conducted a Norwegian population-based nationwide study of 86,306 people to examine the association between the mother's intake of gluten during pregnancy, child's gluten intake at age 18 months, and the risk of type 1 diabetes in the child. The research team included Dr Nicolai Lund-Blix, and colleagues at Oslo University Hospital, and the Norwegian Institute of Public Health in Oslo, Norway. Their research was presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Barcelona, Spain from September 16-20. The outcome was clinical type 1 diabetes cases in the nationwide childhood diabetes registry. The team calculated increased risk using statistical modeling for maternal gluten intake during pregnancy and child's gluten intake at 18 months. The authors estimated grams per day of gluten intake based on a semi-quantitative food frequency questionnaire at week 22 of pregnancy, and from a questionnaire completed by the guardian when the child was 18 months old. Researchers are not calling upon expectant mothers to reduce gluten content in the infant diet at this point in time. According to the authors, "This study suggests that the child's gluten intake at 18 months of age, and not the maternal intake during pregnancy, could increase the risk of type 1 diabetes in the child." Read more at: Diabetes Times and at Celiac.com: High Childhood Gluten Intake Increases Risk of Celiac Disease and Celiac Autoimmunity -
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FDA Urges Transition to Disposable Duodenoscopes
Jefferson Adams posted an article in Additional Concerns
Celiac.com 09/10/2019 - The US Food and Drug Administration (FDA) is recommending that manufacturers of duodenoscopes, along with health care facilities, switch to duodenoscopes with disposable parts to help reduce the risk of patient infection. Post-market surveillance studies ordered by the FDA reveal that contamination rates for reusable duodenoscopes remain unacceptably high after reprocessing, with avoidable deaths and infections still occurring. As a result, the agency is now recommending the elimination of duodenoscopes with fixed endcaps in favor of those with either disposable components, including disposable endcaps, or fully disposable duodenoscopes as they become available. By simplifying or eliminating the need for reprocessing, disposable duodenoscopes may reduce between-patient contamination associated with reusable, or fixed endcaps, says an agency communication. Duodenoscope Transition Will Be Gradual The FDA is urging that the transition to disposable duodenoscopes, or those with disposable parts, be undertaken gradually, as full-market withdrawal of conventional, fixed endcap duodenoscopes is unfeasible, and could trigger a shortage. "We recognize that a full transition away from conventional duodenoscopes to innovative models will take time and immediate transition is not possible for all health care facilities due to cost and market availability," Jeff Shuren, MD, director of the FDA's Center for Devices and Radiological Health, said in the release. Though a slow transition may seem less optimal, "the FDA believes, at this time, the continued availability of these devices is in the best interest of the public health," the agency said. The FDA is working with manufacturers to increase the supply of disposable cap duodenoscopes and develop new device designs that will further reduce or eliminate the risk of patient infection, Shuren said. Specifically, the FDA is recommending healthcare facilities transition away from fixed endcap models, including Olympus Corporation's TJF-Q160, TJF-Q180V, PJF-160, and JF-140F; Fujifilm Medical Systems USA's ED-530XT; and Pentax Medical's ED-3490TK. Read more at Medscape Medical News -
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Genetic Risk for Autoimmune Disease Tied to Gut Microbiome
Jefferson Adams posted an article in Latest Research
Celiac.com 09/04/2019 - Class II human leukocyte antigen (HLA) allele combinations exert strong genetic control over susceptibility to numerous autoimmune diseases. Researchers know that these genes are the most significant risk factors for Type 1 diabetes and celiac disease, but they still know very little about how HLA influences the makeup of the human gut microbiome, which could be an environmental factor for disease susceptibility. A team of researchers recently compared the gut microbiomes of kids with high genetic risk for Type 1 diabetes against those of kids with low genetic risk. Their results show that the two groups have very different gut microbiomes. The research team included Jordan T. Russell, Luiz F. W. Roesch, Malin Ördberg, Jorma Ilonen, Mark A. Atkinson, Desmond A. Schatz, Eric W. Triplett and Johnny Ludvigsson. Using data from a study of All Babies in Southeast Sweden, the team found that genetic risk for the development of Type 1 diabetes autoimmunity is associated with clear changes in the gut microbiome, with both core microbiome and beta diversity differing according to HLA risk group and genotype. Interestingly, protective HLA haplotypes are connected with bacterial genera Intestinibacter and Romboutsia. These results show that general population cohorts can help researchers spot potential environmental triggers or protective factors for autoimmune diseases that can otherwise remain obscured by strong genetic influence. Certain bacterial species were totally absent in children with high genetic risk, but present in children with low or no risk. "[T]his could mean that certain species [of gut bacteria] have protective effects and may be useful in future treatment to prevent autoimmune diseases. It may be that certain species cannot survive in individuals with high genetic risk”, says Johnny Ludvigsson, senior professor in the Department of Clinical and Experimental Medicine, Linköping University, and senior consultant at HRH Crown Princess Victoria Children’s Hospital, Linköping University Hospital. Read more in Nature Communications volume 10, Article number: 3621 (2019) The researchers in this study are variously affiliated with the Department of Microbiology and Cell Science, Institute of Food and Agricultural Sciences University of Florida, Gainesville, FL, USA; the Biological Sciences, Universidade Federal do Pampa, São Gabriel, Brazil; the Crown Princess Victoria Children’s Hospital, Region Östergötland, Division of Pediatrics, Linköping University, Linköping, Sweden; the Immunogenetics Laboratory, Institute of Biomedicine, University of Turku, and Clinical Microbiology, Turku University Hospital, Turku, Finland; the Department of Pathology, University of Florida Diabetes Institute, Gainesville, FL, USA; the Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA; and the Department of Microbiology and Cell Science, Institute of Food and Agricultural Sciences University of Florida, Gainesville, FL, USA. -
Celiac.com 08/26/2019 - Does the amount of gluten consumed during the first 5 years of life influence the risk of celiac disease autoimmunity and celiac disease in at-risk children? A new study says it does. There's been some previous study data to suggest that high gluten intake during childhood may increase risk of celiac disease. A team of researchers working for The Environmental Determinants of Diabetes in the Young (TEDDY) study group recently set out to investigate if gluten intake levels are associated with celiac disease autoimmunity and celiac disease in genetically at-risk children. The TEDDY group is a prospective observational birth cohort study designed to identify environmental triggers of type 1 diabetes and celiac disease. The research team included Carin Andrén Aronsson, PhD; Hye-Seung Lee, PhD; Elin M. Hård af Segerstad, MSc; et al Ulla Uusitalo, PhD; Jimin Yang, PhD; Sibylle Koletzko, MD, PhD; Edwin Liu, MD, PhD; Kalle Kurppa, MD, PhD; Polly J. Bingley, MD; Jorma Toppari, MD, PhD; Anette G. Ziegler, MD; Jin-Xiong She, PhD; William A. Hagopian, MD, PhD; Marian Rewers, MD, PhD; Beena Akolkar, PhD; Jeffrey P. Krischer, PhD; Suvi M. Virtanen, MD, PhD; Jill M. Norris, MPH, PhD; Daniel Agardh, MD, PhD; for the TEDDY Study Group For their multinational prospective birth study, the team looked at gluten consumption in 6,605 genetically predisposed children in 6 clinical centers in Finland, Germany, Sweden, and the United States. The team defined celiac disease autoimmunity as positive tissue transglutaminase autoantibodies found in 2 consecutive serum samples. The team defined celiac disease as cases confirmed by intestinal biopsy or persistently high tissue transglutaminase autoantibody levels. The team estimated gluten intake from 3-day food records collected at ages 6, 9, and 12 months and biannually thereafter until the age of 5 years. Their results showed that children with higher gluten intake levels had a significantly higher risk of celiac disease autoimmunity, with an absolute risk difference of 6.1%. Children with higher gluten intake levels also had a significantly higher risk of celiac disease, with an absolute risk difference of 7.2%, for every gram increase of gluten intake per day. This study shows that genetically predisposed children with higher gluten intake during the first 5 years of life face an increased risk of celiac disease autoimmunity and celiac disease. Read more at JAMA. 2019;322(6):514-523. doi:10.1001/jama.2019.10329 The researchers are variously affiliated with the Department of Clinical Sciences, Lund University, Malmö, Sweden; the Health Informatics Institute, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa; the Dr von Hauner Children’s Hospital, Ludwig Maximilians University, Munich, Germany; the University of Warmia and Mazuri, Olsztyn, Poland; the Digestive Health Institute, University of Colorado Denver, Children’s Hospital Colorado, Denver; the Tampere Centre for Child Health Research, University of Tampere, Tampere University Hospital, Tampere, Finland; the School of Clinical Sciences, University of Bristol, Bristol, England; Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, Turku, Finland; Department of Pediatrics, Turku University Hospital, Turku, Finland; the Institute of Diabetes Research, Helmholtz Zentrum München, Klinikum rechts der Isar, Technische Universität München, and Forschergruppe Diabetes eV, Neuherberg, Germany; the Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, Georgia; Pacific Northwest Diabetes Research Institute, Seattle, Washington; the Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora; the National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland; the National Institute for Health and Welfare, Department of Public Health Solutions, Helsinki, Finland; the Faculty of Social Sciences/Health Sciences, University of Tampere, Tampere, Finland; the Research Center for Child Health, Tampere University, University Hospital, Science Center of Pirkanmaa Hospital District, Tampere, Finland; and the Colorado School of Public Health, Department of Epidemiology, University of Colorado, Aurora, Colorado. -
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Celiac.com 08/01/2019 - Rates of celiac disease have climbed steeply in recent decades in some developed countries. However, there really isn't much in the current medical literature to clearly explain the increase. Researchers Seth Scott Bittker and Kathleen Roberta Bell recently set out to determine whether nine variables are associated with the development of celiac disease in children. They are variously affiliated with the Interdisciplinary Center for Innovative Theory and Empirics (INCITE), Columbia University, New York, New York, US; and the Ontario College of Teachers, Toronto, Ontario, Canada. The team looked at the following variables: "incidence of ear infection before 2 years old, courses of antibiotics before 2 years old, duration of breastfeeding, vitamin D drop exposure in infancy, vitamin D supplement exposure between 2–3 years old, age at gluten introduction into the diet, fat content of cow’s milk consumed between 2–3 years old, quantity of cow’s milk consumed between 2–3 years old, and type of water consumed at 2 years old." To gather their data, the team used an internet survey to quiz parents living in the US with at least one biological child between 3 and 12 years old. To recruit participants, the team used social media, websites, electronic newsletters, and advertisements. The team ended up with a total of 332 responses for children with celiac disease, and 241 responses from the non-celiac control group. The team's data showed that skim liquid cow’s milk consumed between 2–3 years old, vitamin D drops used for longer than 3 months, early doses of antibiotics, and early ear infection are all associated with later development of celiac disease in children. This study found a connection between skim milk consumption, and vitamin D drop use for more than 3 months, and later development of celiac disease. It also found evidence to support earlier data that early life exposure to antibiotics and early life infection, especially ear infection, are also associated with the development of celiac disease in children. Read more in Clinical and Experimental Gastroenterology -
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Celiac.com 06/24/2019 - A team of researchers recently set out to assess whether maternal diet during pregnancy plays any role in the later development of celiac disease in their children. Among other things, they found that moms who eat a high-fiber diet during pregnancy could reduce the chances of their children getting celiac disease later on, according to a new study, which is one of the first to investigate the link between fiber intake during pregnancy and children's risk of celiac disease. In the study, a team of researchers analyzed information from more than 88,000 Norwegian children and their mothers, who gave birth between 1999 and 2009. The research team included Dr. Ketil Størdal, a research professor at the Norwegian Institute of Public Health and a pediatric gastroenterologist at Østfold Hospital Trust in Norway, and other colleagues. The mothers answered questions about their fiber and gluten intake in their 22nd week of pregnancy, and the researchers tracked the children for about 11 years to see if any developed celiac disease. Kids of High Fiber Moms Have Lower Celiac Risk The researchers found that children born to mothers who ate the most fiber (over 45 grams per day) were 34% less like to develop celiac disease, compared with mothers who ate less than 19 grams of fiber per day. Mom's Fiber Intake May Influence Gut Bacteria in Kids It's known that fiber affects gut bacteria, aka, the gut "microbiome." Indeed, some studies have found that gut bacteria, aka, the gut "microbiome" is different in people with celiac disease than in those without it. The researchers think that the fiber levels of the mom might influence her child's gut flora, which could then reduce the child's celiac disease risk. The researchers cautioned people not to read too much into the early findings. The team, says Dr. Størdal, "cannot yet recommend any specific dietary measures during pregnancy to prevent celiac disease, and this needs to be further studied." No Connection to Gluten-Free Diet However, the study found no evidence for a link between the mother's gluten intake and her child's risk of celiac disease. The study's findings, said Dr. Størdal, "do not support gluten restriction for pregnant women." The study will be presented Friday (June 7) at the annual meeting of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). It has not yet been published in a peer-reviewed journal. Read more at Medicalxpress.com -
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Celiac.com 05/22/2019 - What are the risks for lymphoma and gastrointestinal cancer in patients 55 years and older with newly diagnosed adult-onset celiac disease? Researchers and clinicians have reported connections between celiac disease and the development of certain lymphoid and gastrointestinal (GI) cancers, but there just isn't much good data. Without good data, it's impossible to develop effective evidence-based follow-up protocols. In an effort to develop better information on the subject, a team of researchers recently set out to determine relative (RR) and absolute risks of lymphoma and GI carcinoma for newly diagnosed adult celiac patients. The research team included Tom van Gils, Petula Nijeboer, Lucy IH Overbeek, Michael Hauptmann, Daan AR Castelijn, Gerd Bouma, Chris JJ Mulder, Flora E van Leeuwen, and Daphne de Jong. They are variously affiliated with the Celiac Center Amsterdam, Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam, the Netherlands; the Foundation PALGA (The Nationwide Network and Registry of Histo- and Cytopathology in the Netherlands), Houten, the Netherlands; the Department of Epidemiology and Biostatistics, the Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, the Netherlands; and the Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands. To assess RR with cases (lymphoma or GI carcinoma) and controls--melanoma or basal cell carcinoma diagnosed from 1994–2014, the team conducted a case-control design using the Dutch nationwide population-based pathology database (PALGA). Among this group, the team identified patients with prior histologically proven or simultaneously diagnosed with the malignancy. The team found celiac disease in a total of 349 of 301,425 cases (0.1%) and 282 of 576,971 (0.05%) control subjects. Adults diagnosed with celiac disease had a substantially higher risk of T-cell lymphoma, mainly enteropathy-associated T-cell lymphoma (EATL). Clinicians should look out for EATL (both intestinal and extra-intestinal) and small bowel adenocarcinoma in patients with celiac disease diagnosed at 50 years of age or later. Although most often synchronously diagnosed, risk of T-cell lymphoma 1 year or more after celiac disease diagnosis was still elevated at 12.7 (95% CI 7.6–21.3). Other celiac disease-associated malignancies were small bowel adenocarcinoma, with RR of 11.9 (95% CI 8.2–17.2), and esophageal squamous cell carcinoma (RR = 3.5 (95% CI 2.1–5.8)). Absolute risks of developing these cancers were relatively low. Celiac disease did not show any higher risk of developing other types of lymphomas and GI carcinomas. Read more in the United European Gastroenterology Journal -
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Celiac.com 05/13/2019 - You might remember earlier headlines touting lower celiac disease risk in people who smoke cigarettes compared with people who never smoked. Several studies have shown a negative association between cigarette smoking and celiac disease, but results have been inconsistent. A study published in 2004 in the European Journal of Gastroenterology & Hepatology, found that cigarette smoking provided protection against the development of adult celiac disease. In a 2015 letter to the editors of the American Journal of Gastroenterology regarding the study "Incidence and prevalence of celiac disease and dermatitis herpetiformis in the UK over two decades: population-based study" by West et al., Dr. S. Veldhuyzen van Zanten, MD, PhD, of the Division of Gastroenterology, University of Alberta in Edmonton, Alberta, Canada, wonders whether lower rates of cigarette smoking in the preceding decades "might help explain the study findings." So, do cigarette smokers have a lower risk of celiac disease than non-smokers? To find a conclusive answer, a team of researchers recently set out to summarize all available data, using meta-analysis, and to demonstrate any decreased risk of celiac disease among current smokers compared with people who never smoked. The research team included Karn Wijarnpreecha, Susan Lou, Panadeekarn Panjawatanan, Wisit Cheungpasitporn, Surakit Pungpapong, Frank J. Lukens, and Patompong Ungprasert. The team used MEDLINE and Embase databases to identify all group studies and case-control studies that compared the risk of celiac disease among current and/or former smokers versus people who never smoked. They then extracted the effect estimates from each study and combined them using the random-effect, generic inverse variance method of DerSimonian and Laird. The team's meta-analysis of seven studies, with 307,924 total participants, showed that current smokers have a substantially reduced risk of celiac disease compared with those who never-smoked. However, they found no significant difference in celiac disease risk between former smokers and those who never smoked. The team suggests that the impact of cigarette smoking on immune system and gut permeability are the likely biological reasons for earlier findings. Read more at Sagepub.com The researchers are variously affiliated with the Department of Internal Medicine, Bassett Medical Center, Cooperstown, USA; the Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Mayo Clinic, Jacksonville, USA; the Department of Medicine, University of Minnesota, Minneapolis, USA; the Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; the Department of Medicine, Division of Nephrology, University of Mississippi Medical Center, Jackson, USA; and the Clinical Epidemiology Unit, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. -
Celiac.com 05/14/2019 - A strict gluten-free diet is the only proven treatment for celiac disease, yet researchers still don't know what effect, if any, the diet might have on risk factors for cardiovascular disease. A team of researchers recently set out to determine whether following a gluten-free diet influences risk factors for cardiovascular disease among newly diagnosed pediatric celiac disease subjects. Their results suggest that a gluten-free diet does not increase cardiovascular disease risk, at least in the short-term. The research team included E Zifman, O Waisbourd-Zinman, L Marderfeld, N Zevit, A Guz-Mark, A Silbermintz, A Assa, Y Mozer-Glassberg, N Biran, D Reznik, I Poraz, and R Shamir. They are variously affiliated with the Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva; Pediatric Gastroenterology Clinic, Pediatric Division, Meir Medical Center, Kfar-Saba; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; and the Clinical Nutrition and Dietetics Department, Schneider Children's Medical Center of Israel, Petach-Tikva. For their study, the team prospectively enrolled pediatric patients receiving upper gastrointestinal endoscopy for suspected celiac disease. Team members recorded physical and lab data related to cardiovascular disease risk, both at celiac diagnosis and after 1 year following a gluten-free diet, and assessed any variation in risk fo cardiovascular disease. The team used both paired tests or Wilcoxon nonparametric tests, as needed. In this study, children with celiac disease showed no increase in cardiovascular disease risk factors after one year on a strict gluten-free diet. The results did show a small increase in median fasting insulin levels, but no increase in insulin resistance as measured by homeostatic model assessment. During the same period, rates of dyslipidemia remained steady, while median high-density lipoprotein levels increased. The long-term implications of these small changes is not clear. So, at least in the short run, it looks like a gluten-free diet doesn't increase risk for cardiovascular disease in children with celiac disease. Further study is needed to determine if that's true long-term. Read more at the Journal of Pediatric Gastroenterology & Nutrition; 2019 May;68(5):684-688.-
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