Tags

Type your tag names separated by a space and hit enter

A nationwide cohort study of the risk of chronic obstructive pulmonary disease in coeliac disease.

Abstract

OBJECTIVE

Chronic obstructive pulmonary disease (COPD) continues to be an important cause of morbidity, mortality and healthcare costs in the western world. Although smoking is an important trigger of COPD, other factors such as chronic inflammation and malnutrition are known to influence its development. Because coeliac disease (CD) is characterized both by dysregulated inflammation and malnutrition, the possibility of an association between CD and COPD was investigated.

METHODS

Through biopsy data from all Swedish pathology departments, we identified 10 990 individuals with CD who were biopsied between 1987 and 2008 (Marsh 3: villous atrophy). As controls, 54 129 reference individuals matched for age, sex, county and calendar year of first biopsy were selected. Cox regression analysis was then performed to estimate hazard ratios (HRs) for having a diagnosis of COPD according to the Swedish Patient Register.

RESULTS

During follow-up, 380 individuals with CD (3.5%) and 1391 (2.6%) controls had an incident diagnosis of COPD, which corresponds to an HR of 1.24 (95% CI: 1.10-1.38) and an excess risk of COPD of 79/100 000 person-years in CD. The risk increase remained 5 years after biopsy (HR = 1.17; 95% CI: 1.00-1.37). Risk estimates did not change with adjustment for type 1 diabetes, thyroid disease, rheumatoid arthritis, country of birth or level of education. Men with CD were at a higher risk of COPD (HR = 1.39; 95% CI: 1.18-1.62) than women with CD (HR = 1.11; 95% CI: 0.94-1.30). Of note, CD was also associated with COPD before CD diagnosis (odds ratio = 1.22; 95% CI: 1.02-1.46). Conclusion.  Patients with CD seem to be at a moderately increased risk of COPD both before and after CD diagnosis.

Links

  • FREE Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Paediatrics, Örebro University Hospital, Örebro, Sweden. jonasludvigsson@yahoo.com

    , ,

    Source

    Journal of internal medicine 271:5 2012 May pg 481-9

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Biopsy
    Celiac Disease
    Comorbidity
    Female
    Humans
    Incidence
    Inflammation
    Intestinal Mucosa
    Male
    Malnutrition
    Middle Aged
    Odds Ratio
    Population Surveillance
    Pulmonary Disease, Chronic Obstructive
    Regression Analysis
    Risk Factors
    Sweden

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    21880073

    Citation

    Ludvigsson, J F., et al. "A Nationwide Cohort Study of the Risk of Chronic Obstructive Pulmonary Disease in Coeliac Disease." Journal of Internal Medicine, vol. 271, no. 5, 2012, pp. 481-9.
    Ludvigsson JF, Inghammar M, Ekberg M, et al. A nationwide cohort study of the risk of chronic obstructive pulmonary disease in coeliac disease. J Intern Med. 2012;271(5):481-9.
    Ludvigsson, J. F., Inghammar, M., Ekberg, M., & Egesten, A. (2012). A nationwide cohort study of the risk of chronic obstructive pulmonary disease in coeliac disease. Journal of Internal Medicine, 271(5), pp. 481-9. doi:10.1111/j.1365-2796.2011.02448.x.
    Ludvigsson JF, et al. A Nationwide Cohort Study of the Risk of Chronic Obstructive Pulmonary Disease in Coeliac Disease. J Intern Med. 2012;271(5):481-9. PubMed PMID: 21880073.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A nationwide cohort study of the risk of chronic obstructive pulmonary disease in coeliac disease. AU - Ludvigsson,J F, AU - Inghammar,M, AU - Ekberg,M, AU - Egesten,A, Y1 - 2011/09/22/ PY - 2011/9/2/entrez PY - 2011/9/2/pubmed PY - 2012/7/18/medline SP - 481 EP - 9 JF - Journal of internal medicine JO - J. Intern. Med. VL - 271 IS - 5 N2 - OBJECTIVE: Chronic obstructive pulmonary disease (COPD) continues to be an important cause of morbidity, mortality and healthcare costs in the western world. Although smoking is an important trigger of COPD, other factors such as chronic inflammation and malnutrition are known to influence its development. Because coeliac disease (CD) is characterized both by dysregulated inflammation and malnutrition, the possibility of an association between CD and COPD was investigated. METHODS: Through biopsy data from all Swedish pathology departments, we identified 10 990 individuals with CD who were biopsied between 1987 and 2008 (Marsh 3: villous atrophy). As controls, 54 129 reference individuals matched for age, sex, county and calendar year of first biopsy were selected. Cox regression analysis was then performed to estimate hazard ratios (HRs) for having a diagnosis of COPD according to the Swedish Patient Register. RESULTS: During follow-up, 380 individuals with CD (3.5%) and 1391 (2.6%) controls had an incident diagnosis of COPD, which corresponds to an HR of 1.24 (95% CI: 1.10-1.38) and an excess risk of COPD of 79/100 000 person-years in CD. The risk increase remained 5 years after biopsy (HR = 1.17; 95% CI: 1.00-1.37). Risk estimates did not change with adjustment for type 1 diabetes, thyroid disease, rheumatoid arthritis, country of birth or level of education. Men with CD were at a higher risk of COPD (HR = 1.39; 95% CI: 1.18-1.62) than women with CD (HR = 1.11; 95% CI: 0.94-1.30). Of note, CD was also associated with COPD before CD diagnosis (odds ratio = 1.22; 95% CI: 1.02-1.46). Conclusion.  Patients with CD seem to be at a moderately increased risk of COPD both before and after CD diagnosis. SN - 1365-2796 UR - https://www.unboundmedicine.com/medline/citation/21880073/A_nationwide_cohort_study_of_the_risk_of_chronic_obstructive_pulmonary_disease_in_coeliac_disease_ L2 - https://doi.org/10.1111/j.1365-2796.2011.02448.x DB - PRIME DP - Unbound Medicine ER -