Morbidity and Mortality Among Older Individuals With Undiagnosed Celiac Disease
| Autor: | Alan R. Zinsmeister, Joseph A. Murray, L. Joseph Melton, Brian D. Lahr, Carol T. Van Dyke, Deanna L. Brogan, Waleed Brinjikji, Joseph J. Larson, Kevin N. Christensen, Robert A. Kyle, Alberto Rubio–Tapia, Tricia L. Brantner, Jonathan D. Godfrey |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Minnesota Population Comorbidity Kaplan-Meier Estimate Article Body Mass Index Hypothyroidism Bone Density GTP-Binding Proteins Internal medicine Epidemiology Odds Ratio Prevalence medicine Humans Protein Glutamine gamma Glutamyltransferase 2 education Aged Autoantibodies Proportional Hazards Models Aged 80 and over education.field_of_study Transglutaminases Hepatology Proportional hazards model business.industry Age Factors Gastroenterology Case-control study Odds ratio Middle Aged medicine.disease Health Surveys Celiac Disease Cholesterol Logistic Models Case-Control Studies Ferritins Cohort Immunology Osteoporosis Female business Body mass index Biomarkers |
| Zdroj: | Gastroenterology. 139:763-769 |
| ISSN: | 0016-5085 |
| DOI: | 10.1053/j.gastro.2010.05.041 |
| Popis: | Background & Aims Outcomes of undiagnosed celiac disease (CD) are unclear. We evaluated the morbidity and mortality of undiagnosed CD in a population-based sample of individuals 50 years of age and older. Methods Stored sera from a population-based sample of 16,886 Olmsted County, Minnesota, residents 50 years of age and older were tested for CD based on analysis of tissue transglutaminase and endomysial antibodies. A nested case-control study compared serologically defined subjects with CD with age- and sex-matched, seronegative controls. Medical records were reviewed for comorbid conditions. Results We identified 129 (0.8%) subjects with undiagnosed CD in a cohort of 16,847 older adults. A total of 127 undiagnosed cases (49% men; median age, 63.0 y) and 254 matched controls were included in a systematic evaluation for more than 100 potentially coexisting conditions. Subjects with undiagnosed CD had increased rates of osteoporosis and hypothyroidism, as well as lower body mass index and levels of cholesterol and ferritin. Overall survival was not associated with CD status. During a median follow-up period of 10.3 years after serum samples were collected, 20 cases but no controls were diagnosed with CD (15.2% Kaplan–Meier estimate at 10 years). Conclusions With the exception of reduced bone health, older adults with undiagnosed CD had limited comorbidity and no increase in mortality compared with controls. Some subjects were diagnosed with CD within a decade of serum collection, indicating that although most cases of undiagnosed CD are clinically silent, some result in symptoms. Undiagnosed CD can confer benefits and liabilities to older individuals. |
| Databáze: | OpenAIRE |
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