Search the Community

Celiac.com 10/23/2024 - Cardiovascular diseases, such as coronary artery disease and stroke, have long been connected with various immune-mediated disorders due to the role inflammation plays in both conditions. This study explores whether there is a genetic connection between cardiovascular diseases and specific immune-mediated diseases, with a particular focus on psoriasis. Psoriasis is a chronic inflammatory condition that has previously been associated with an increased risk of cardiovascular disease. However, it is unclear whether the genetic risk factors for cardiovascular disease are also linked to an increased risk of psoriasis and other immune-related conditions. Study Objectives The main goal of the study was to investigate whether genetic predispositions to coronary artery disease and stroke also increase the risk of developing psoriasis or other immune-mediated diseases. The researchers utilized a method called Mendelian randomization, which uses genetic data to determine whether there is a causal relationship between two traits, as opposed to just an observed association. By using large datasets from genome-wide association studies, the study aimed to uncover whether genetic predictors of cardiovascular disease are directly linked to immune-mediated diseases, such as psoriasis, rheumatoid arthritis, and inflammatory bowel disease. Methods and Data To conduct the analysis, the study used Mendelian randomization to evaluate the genetic links between cardiovascular disease and immune-mediated diseases. This approach is particularly effective in differentiating causality from correlation because it uses genetic markers as proxies for risk factors. The researchers analyzed summary data from genome-wide association studies for coronary artery disease, stroke, psoriasis, and nine other immune-mediated diseases. The data included a large sample of participants, with over 1.1 million individuals for cardiovascular disease traits and nearly 500,000 for psoriasis. The study specifically examined whether genetic markers associated with coronary artery disease and stroke were linked to an increased risk of developing psoriasis or any of the other immune-mediated diseases. Key Findings The results of the study revealed that genetic predictors for both coronary artery disease and stroke were significantly associated with an increased risk of psoriasis. In particular, genetic risk factors for coronary artery disease were found to increase the risk of developing psoriasis by about 7%, while genetic risk factors for stroke increased the risk by 22%. Interestingly, when adjustments were made for stroke risk, the association between coronary artery disease and psoriasis became statistically insignificant. This suggests that there may be a shared genetic component that links both cardiovascular diseases and psoriasis, rather than two separate pathways. On the other hand, the study found no significant genetic link between cardiovascular disease risk factors and other immune-mediated diseases, such as rheumatoid arthritis and inflammatory bowel disease. This finding was somewhat unexpected, as these diseases also involve inflammation, which is thought to be a common factor in both cardiovascular disease and immune-mediated disorders. Genetic Risk and Celiac Disease The study also explored the relationship between genetic predictors of cardiovascular disease and various immune-mediated diseases, including celiac disease. Data from 4,533 cases of celiac disease and 10,750 controls were included in the analysis. The results indicated no significant association between genetic risk factors for cardiovascular disease—such as coronary artery disease or stroke—and the risk of developing celiac disease. This finding suggests that while cardiovascular genetic factors may influence the risk of developing psoriasis, they do not appear to have the same effect on celiac disease or other immune-mediated conditions. Understanding the Relationship Between Psoriasis and Cardiovascular Disease The discovery that genetic risk factors for cardiovascular disease are linked specifically to psoriasis, but not to other immune-mediated diseases, points to the possibility of a unique shared biological mechanism. Psoriasis is a disease driven by inflammation, and inflammation is also a key factor in the development of cardiovascular diseases like coronary artery disease and stroke. However, the study’s findings suggest that this connection may not extend to all immune-mediated diseases, challenging previous assumptions about the broad relationship between cardiovascular disease and inflammation-driven conditions. One possible explanation for this connection could lie in the specific inflammatory pathways involved in both cardiovascular disease and psoriasis. Psoriasis is known to involve certain inflammatory cellular and cytokine pathways, and these same pathways may play a role in the development of cardiovascular disease. However, these pathways may not be as significant in other immune-mediated diseases, which could explain the lack of genetic association with conditions like rheumatoid arthritis and inflammatory bowel disease. Implications for Treatment and Future Research The findings of this study have several important implications. First, they highlight the need for further research into the shared genetic mechanisms underlying cardiovascular disease and psoriasis. Understanding these mechanisms could lead to the development of new treatments that target both conditions. For example, therapies that reduce inflammation in psoriasis patients could potentially help lower their risk of cardiovascular disease, and vice versa. Second, the study underscores the importance of personalized medicine. As more is learned about the genetic links between different diseases, it becomes increasingly possible to develop tailored treatments that address an individual's unique genetic risk factors. For patients with psoriasis who are also at risk for cardiovascular disease, this could mean more targeted interventions that address both conditions simultaneously. Implications for Those with Celiac Disease The study’s findings highlight the importance of understanding the genetic overlap between cardiovascular disease and psoriasis, but they also underline the distinction when it comes to celiac disease. For those with celiac disease, the results are reassuring as they show no genetic link between cardiovascular risks and the condition. This separation emphasizes that while shared inflammatory pathways may exist between certain immune-mediated diseases and cardiovascular disease, celiac disease does not appear to be influenced by these cardiovascular genetic factors. As such, this research may provide a better understanding of how different immune-mediated diseases interact with cardiovascular health, guiding future research and treatment strategies. Read more at: jamanetwork.com

Celiac.com 11/14/2022 - Some studies have linked coronary artery disease with celiac disease, but hard evidence is scant. To date, there has been no solid medical literature on common risk factors linking celiac disease and coronary artery disease. Risk factors for coronary artery disease include hypertension, hyperlipidemia, type 2 diabetes, obesity, and tobacco use. However, common risk factors connecting celiac disease and coronary artery disease are poorly documented. A team of researchers recently set out with three goals. First, to assess potential demographic differences between celiac patients with coronary artery disease and without coronary artery disease. Secondly, to examine the risk factors of coronary artery disease in celiac patients. Lastly, to compare celiac-coronary artery disease patients and matched non-celiac coronary artery disease to see if there are more coronary artery disease risks for people with celiac disease. The research team included Maryam B. Haider, Paul Naylor, Avijit Das, Syed M. Haider, and Murray N. Ehrinpreis. They are variously affiliated with the Department of Gastroenterology Gastroenterology at Wayne State University in Detroit, MI; the DMC/Wayne State University - Sinai Grace Hospital in Detroit, MI; the Wayne State University School of Medicine in Detroit, MI; and Binghamton University in Binghamton, NY. For their nationwide retrospective case-control study, the team used the National Inpatient Sample (NIS) database to identify patients admitted between 2016 and 2018 with a principal or secondary diagnosis of celiac disease. They then assessed sociodemographic and clinical risk factors for coronary artery disease in celiacs, and compared the celiac-coronary artery disease patients with the matched non-celiac coronary artery disease group. Of nearly 24,000 hospitalizations with celiac disease from 2016 to 2018, nearly 20%, were found to have coronary artery disease. Established coronary artery disease risk factors for celiac patients included hypertension, hyperlipidemia, type 2 diabetes, and a family history of coronary artery disease. Interestingly, tobacco use is not a coronary artery disease risk factor in celiac patients. Odds of coronary artery disease were 55% less likely for female celiac patients, compared to male patients. The odds of coronary artery disease were 20% greater in patients with essential hypertension, double in patients with type 2 diabetes, and five times higher in celiac patients with hyperlipidemia. Patients with coronary artery disease had higher rates of iron deficiency anemia, which were nearly 10% for celiac-coronary artery disease patients, compared with just under 8.3% for non-coronary artery disease celiac patients, and just over 7.3% for people with non-celiac coronary artery disease. The team's findings confirm that, as with non-celiac individuals, males and individuals of Caucasian race with celiac disease face a higher risk of coronary artery disease. They also confirmed that celiac-coronary artery disease patients have a higher rates of hyperlipidemia than non-celiac coronary artery disease patients, while celiacs with type 1 diabetes have an early diagnosis of coronary artery disease, compared to celiacs with type 2 diabetes. Lastly, they found that iron deficiency anemia is an important risk factor for coronary artery disease in those with celiac disease. Teasing out the common links and risk factors for celiac disease and coronary artery disease is important work, and this study helps to advance that cause. Clearly further, and larger, study will be helpful in our ongoing journey to understand the puzzle that makes up the links celiac, coronary artery disease, and other diseases. Read more in Cureus 14(6): e26151