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Yuan S, Kim JH, Xu P, Wang Z. Causal association between celiac disease and inflammatory bowel disease: A two-sample bidirectional Mendelian randomization study. Front Immunol 2023; 13:1057253. [PMID: 36685511 PMCID: PMC9845610 DOI: 10.3389/fimmu.2022.1057253] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023] Open
Abstract
Background An epidemiological link between celiac disease (CeD) and inflammatory bowel disease (IBD) has been well established recently. In this study, Mendelian randomization (MR) analysis was performed employing pooled data of publicly available genome-wide association studies (GWAS) to determine the causal relationship between CeD and IBD, encompassing ulcerative colitis (UC) and Crohn's disease (CD). Methods Dataset of CeD was acquired from GWAS for 12,041 cases and 12,228 controls. A GWAS of more than 86,000 patients and controls was used to identify genetic variations underlying IBD. MR analyses were performed with an inverse-variance-weighted approach, an MR-Egger regression, a weighted-mode approach, a weighted-median method, and sensitivity analyses of MR pleiotropy residual sum and outlie (MR-PRESSO). Results MR demonstrated that genetic predisposition to CeD was linked to a augmented risk of IBD (OR: 1.1408; 95% CI: 1.0614-1.2261; P = 0.0003). In the analysis of the two IBD subtypes, genetic predisposition to CeD was also linked to increased risks of UC (OR: 1.1646; 95% CI: 1.0614-1.2779; P = 0.0012) and CD (OR: 1.1865; 95% CI: 1.0948-1.2859; P = 3.07E-05). Reverse MR analysis results revealed that genetic susceptibility to IBD and CD was correlated with an augmented risk of CeD. However, there was no genetic correlation between UC and CeD. All of the above results were validated with other GWAS databases. Conclusion There is a bidirectional causal relationship of CeD with IBD and CD. However, UC only augments the risk of developing CeD.
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Affiliation(s)
- Shuai Yuan
- Division of Pancreatobiliary Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Ji Hun Kim
- Division of Pancreatobiliary Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Republic of Korea,*Correspondence: Ji Hun Kim,
| | - Pai Xu
- Department of Orthopaedic Surgery, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Zhao Wang
- Department of Orthopaedic Surgery, Chungnam National University School of Medicine, Daejeon, Republic of Korea
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Diets for inflammatory bowel disease: What do we know so far? Eur J Clin Nutr 2022; 76:1222-1233. [PMID: 35064219 DOI: 10.1038/s41430-021-01051-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 11/11/2021] [Accepted: 11/17/2021] [Indexed: 02/06/2023]
Abstract
In recent years, the role of diet in the pathogenesis of inflammatory bowel disease (IBD) has gained great interest within the scientific community. Eating habits from industrialised countries (the so-called western diet or WD) have been associated with a higher incidence of IBD in observational studies, although the dietary factors responsible for the development of the disease are still to be elucidated. Some components of the diet with proinflammatory potential may cause changes in immunity and intestinal microbiota, leading to the inflammatory reaction that causes IBD-related lesions. The quality of available evidence is low, due to methodological issues, such as the lack of intervention studies, small sample size and heterogeneity of studies. For this reason, scientific societies have offered their recommendations using clinical practice guidelines and consensus documents, in order to establish a common criterion in the nutritional treatment of patients with IBD. The objective of this review was to summarise the data published regarding diet in IBD and review the recommendations given by scientific societies.
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Alkhayyat M, Abureesh M, Almomani A, Abou Saleh M, Zmaili M, El Ouali S, Mansoor E, Rubio-Tapia A, Regueiro M. Patients With Inflammatory Bowel Disease on Treatment Have Lower Rates of Celiac Disease. Inflamm Bowel Dis 2022; 28:385-392. [PMID: 34002219 DOI: 10.1093/ibd/izab084] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND The association between celiac disease and inflammatory bowel disease (IBD) has been studied; however, the impact of IBD therapy on celiac disease is not known. Using a large database, we sought to describe the association of celiac disease and IBD and the impact of IBD treatment. METHODS We queried a large multicenter database (Explorys Inc.), an electronic health record data aggregate from 26 American health care systems. We identified a cohort of patients with celiac disease and IBD between 1999 and 2020 and conducted a statistical analysis using a multivariate model. RESULTS Of the 72,965,940 individuals in the database, 133,400 had celiac disease (0.18%), 191,570 (0.26%) had ulcerative colitis (UC), and 230,670 (0.32%) had Crohn disease (CD). Patients with IBD were more likely to have a diagnosis of celiac disease (odds ratio [OR], 13.680), with a greater association with CD. Treated patients with UC and with CD, respectively, had a lower risk association with celiac disease compared to those not undergoing IBD treatment, specifically corticosteroids (OR, 0.407 and 0.585), 5-aminosalicylates (OR, 0.124 and 0.127), immunomodulators (OR, 0.385 and 0.425), and anti-tumor necrosis factor drugs (OR, 0.215 and 0.242). There was no lower risk association in the vedolizumab group, but there was a higher risk association among the ustekinumab group. CONCLUSIONS In this large dataset, we showed a bidirectional association between celiac disease and IBD that was stronger with CD. Patients with IBD treated using corticosteroids, 5-aminosalicylates, immunomodulators, or anti-tumor necrosis factor drugs had a lower association with celiac disease. Additional studies are required to determine the underlying mechanisms for IBD therapy-related modification of celiac disease incidence.
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Affiliation(s)
- Motasem Alkhayyat
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Mohammad Abureesh
- Department of Internal Medicine, Staten Island University Hospital, Staten Island, New York, USA
| | - Ashraf Almomani
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Mohannad Abou Saleh
- Department of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Mohammad Zmaili
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Sara El Ouali
- Department of Gastroenterology, Cleveland Clinic Abu Dhabi, Al Maryah Island, Abu Dhabi, United Arab Emirates
| | - Emad Mansoor
- Department of Gastroenterology and Hepatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Alberto Rubio-Tapia
- Department of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Miguel Regueiro
- Department of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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Qadi M, Hasosah M, Alamoudi A, AlMansour A, Alghamdi M, Alzahrani F, Alzahrani S, Khawaji B. Pediatric Inflammatory Bowel Disease Associated With Celiac Disease: A Retrospective Study in a Tertiary Care Hospital in Saudi Arabia. Glob Pediatr Health 2021; 8:2333794X211052924. [PMID: 34841009 PMCID: PMC8613891 DOI: 10.1177/2333794x211052924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 09/24/2021] [Indexed: 11/25/2022] Open
Abstract
Background. Inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn’s disease (CD), is a chronic relapsing disease indicated by inflammation of the gastrointestinal tract. Celiac disease (CeD) is a chronic autoimmune disease of the small bowel. The prevalence of CeD in IBD patients is unknown. Some studies have described the coexistence of the 2 diseases in the same patient. This study aimed to investigate the prevalence of CeD in Saudi Arabian children with IBD. Methods. We used a retrospective study design because data can be collected immediately and is easier to analyze afterward. The study was conducted on IBD patients in the Pediatric Gastroenterology Department at National Guard Hospital, Jeddah, Saudi Arabia. We enrolled Saudi patients aged between 1 and 18 years who had been diagnosed with IBD and CeD based on positive biochemical serology and histology from January 2011 to January 2020. We excluded patients with immunodeficiency disorders. Results. Among the 46 enrolled patients with IBD, CeD was identified in 4, and they did not develop any relapses. We discovered that the weight at IBD diagnosis improved significantly compared to current weight (P-value < .0001). We also discovered that the height at diagnosis of IBD improved significantly compared to the current height (P-value < .0001). Additionally, we found no significant associations between UC and CeD (P-value = 1), or CD and CeD (P-value = .625). Conclusion. No significant associations were evident between the prevalence of CeD and IBD. More prospective multicenter studies are needed to clarify the prevalence of CeD in children with IBD.
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Affiliation(s)
- Mamdouh Qadi
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Mohammed Hasosah
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.,Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia
| | - Anas Alamoudi
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Abdullah AlMansour
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Mohammed Alghamdi
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Faisal Alzahrani
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Sultan Alzahrani
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Bader Khawaji
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
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Eskander A, Saadah OI, Abdelrazek AA, Mosli M, Alsufyani HA, Meshaal S, Hasnoon AM, Tarek S, Abdelgalil A. Prevalence of Celiac Disease in Children and Adolescents With Inflammatory Bowel Disease. Cureus 2020; 12:e9977. [PMID: 32983679 PMCID: PMC7510941 DOI: 10.7759/cureus.9977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction The association between inflammatory bowel disease (IBD) - particularly its two main subtypes, ulcerative colitis (UC) and Crohn’s disease (CD) - and celiac disease (CeD) has been attributed to an overlap in the mechanism of immune dysregulation that characterizes these conditions. Owing to the paucity of studies that have explored this condition in pediatric patients, we examined the prevalence of CeD in children with IBD. Materials and methods This is a cross-sectional study of children aged two to 18 years with IBD that were diagnosed between 2016 and 2018. Clinical, demographic, laboratory, and endoscopic data were analysed. Serology for CeD measured the immunoglobulin A tissue transglutaminase (IgA-tTG) antibodies, and the diagnosis was confirmed histologically through small bowel biopsies. Results The study included 101 patients with IBD (83.2% with UC and 16.8% with CD). The mean age was 8.7±4.0 years. Males constituted 59.4% of the cohort, and only 3% had perianal disease. Ileocolonic involvement was reported in 64.7% and non-stricturing and non-penetrating behaviour in 76.7% of CD patients. Pancolitis constituted 45.2% of UC patients. Ten patients (9.9%) had positive serology based on IgA-tTG antibodies, three (approximately 3%) had CeD based on biopsy findings, two patients (2%) had CD, and one patient (1%) had UC. Patients with confirmed CeD had a significantly higher frequency of symptoms of gaseous sensation and bloating (P=0.003) and abdominal distension (P=0.04). Conclusions The prevalence of CeD in Egyptian children with IBD is higher than previously reported in a number of similar studies. Abdominal bloating and gaseous sensation were identified as associated symptoms.
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Affiliation(s)
- Ayman Eskander
- Pediatric Gastroenterology, Cairo University, Cairo, EGY
| | - Omar I Saadah
- Pediatric Gastroenterology, King Abdulaziz University, Jeddah, SAU
| | | | - Mahmoud Mosli
- Internal Medicine/Gastroenterology, King Abdulaziz University, Jeddah, SAU
| | | | | | | | - Sara Tarek
- Pediatric Gastroenterology, Cairo University, Cairo, EGY
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