Less known risk factors, but higher risk of cardiovascular disease in people with celiac disease

People with celiac disease may have fewer risk factors for cardiovascular disease, but still have a higher risk of developing it, according to a study led by researchers from Oxford People Health, published online. magazine online Pharmaceuticals BMJ.

It is not clear what the reasons for this might be and more research is needed to find out the motives behind these associations. This includes the role of a gluten-free dietthat affected people must follow to alleviate symptoms, the study authors said.

About 1% of the UK population has celiac disease-one autoimmune condition caused by an overreaction to gluten, a dietary protein found in wheat, barley, and rye.

The condition is more common in women and is usually diagnosed in children and adolescents or between the ages of 40 and 60, the researchers say.

Published evidence on whether celiac disease is associated with a high risk of cardiovascular disease has been inconsistent, and previous studies have tended not to investigate the potential role of heart treatments. traditional circuit. Risk factorsAs if blood pressure or cholesterol.

To find out whether traditional cardiovascular risk factors might contribute to the association between celiac disease and a high risk of cardiovascular disease (ischemic heart disease, heart attackand stroke), the researchers collected medical data provided by UK Biobank participants.

The UK Biobank is a population-based study that recruited around half a million 40-69 year olds from England, Scotland and Wales between 2006 and 2010.

Of these, 2,083 had celiac disease but no cardiovascular disease when they were recruited. Their cardiovascular health was monitored, using hospital records and linked death certificates, for an average of just over 12 years.

People with celiac disease were more likely to be women—56% versus 71.5%—and white—95% to 99%——than those without the condition.

During the follow-up period, 40,687 cardiovascular disease diagnoses were recorded among all surviving UK Biobank participants.

About 218 of these cases occur in people with celiac disease—equivalent to an annual rate of 9 per 1,000 people—compared to an annual rate of 7.4/1,000 in people without the condition.

This means the risk of cardiovascular disease is 27% higher for people with celiac disease than for those without the condition, after taking into account a range of factors that are likely to influence lifestyle. health and cardiovascular disease.

The risk seems to increase the longer a person lives with their condition—risk increases to 30% in people with celiac disease for less than 10 years, to 34% in people with the condition for 10 years. or many more years.

However, people with celiac disease who have few known risk factors for cardiovascular disease (including being overweight or obese; high systolic blood pressure; a history of smoking; and high cholesterol), are more likely. had a lower BMI and lower systolic blood pressure. .

They were also more likely to have a so-called ideal cardiovascular risk score (23% vs 14%) and less likely to have a low risk score (5% vs 9%) than people with celiac disease. .

When researchers explored the potential overall effects of celiac disease and cardiovascular risk scores on cardiovascular disease, the risk increased by more than 60 percent in people with celiac disease plus an ideal cardiovascular disease risk score. compared with those with an ideal risk score but without celiac disease.

This was an observational study and therefore cannot establish cause and effect. The researchers acknowledge various limitations to their findings, including that cardiovascular disease risk factors were measured only at one point in time.

But some autoimmune conditions are associated with a higher risk of cardiovascular disease due to systemic inflammation, they point out.

The researchers didn’t look at dietary factors, but several previously published studies suggest that a gluten-free diet can reduce inflammation and thus the risk of cardiovascular disease. while other studies indicate that this diet may actually increase the risk.

“This study highlights the importance of cardiovascular disease as a potential complication of celiac disease. Further study of the drivers and mechanistic pathways of this association is warranted. In addition, a warranted investigation into the extent of risk reduction reported by adherence to the gluten-free diet in individuals with celiac disease or whether the gluten-free diet contributes to the increased risk determine or not,” they wrote

“Given the increased rates of cardiovascular disease reported in people with celiac disease, those with ideal and moderate body heart-related diseaes The researchers concluded that clinicians should make celiac disease patients aware of their increased risk and work with their patients to optimize their cardiovascular health.