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A Nationwide Study of the Association Between Celiac Disease and the Risk of Autistic Spectrum Disorders
Jefferson Adams posted an article in Autism and Celiac DiseaseCeliac.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. A 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. Source: JAMA Psychiatry. Published online September 25, 2013. doi:10.1001/jamapsychiatry.2013.2048
Jefferson Adams posted an article in Autism and Celiac DiseaseCeliac.com 04/11/2012 - Studies on the gluten-free and/or casein-free (Gluten-free Casein-free) dietary intervention for children with autism spectrum disorders (ASDs) suggest that some children may positively respond to implementation of the dietary intervention. Other studies support the idea of using various factors, including gastrointestinal (GI) abnormalities and immune function to classify children diagnosed with ASDs Medical researchers Christine M. Pennesi, and Laura Cousino recently examined the effectiveness of the gluten-free, casein-free diet for children diagnosed with autism spectrum disorder. They are affiliated with the Department of Biobehavioral Health at the Pennsylvania State University in Pennsylvania, USA. For their study, Pennesi and Cousino presented a 90-question online survey to parents or primary caregivers of children diagnosed with ASD. The survey asked about the efficacy of the Gluten-free Casein-free diet. The survey included questions about the children's GI symptoms, food allergy diagnoses, and suspected food sensitivities, as well as the degree and length of their dietary regime. In all, they received 387 responses. Parents who reported GI symptoms, food allergy diagnoses, and suspected food sensitivities also reported greater improvement in ASD behaviors, physiological symptoms, and social behaviors, compared with parents who reported symptoms, diagnoses, or sensitivities in their children (P < 0.05). Parents who reported strict diet adherence, full gluten/casein elimination and infrequent diet errors during and outside of parental care, also reported improvement in ASD behaviors, physiological symptoms, and social behaviors, compared with parents who reported less strict adherence, incomplete gluten/casein elimination, and more frequent diet errors during and outside of parental care (P < 0.05). The full report appears in Nutritional Neuroscience. There, the authors write that findings suggest that diet adherence and GI and immune factors may help to differentiate diet responders from diet non-responders. They also suggest that the findings support the importance of further investigations into the various factors that influence efficacy of treatment in children with ASDs. Source: Nutritional Neuroscience