Dietary Gluten Intake and Risk of Microscopic Colitis Among US Women without Celiac Disease: A Prospective Cohort Study

Liu, Po Hong; Lebwohl, Benjamin; Burke, Kristin E.; Ivey, Kerry L.; Ananthakrishnan, Ashwin N.; Lochhead, Paul; Olén, Ola; Ludvigsson, Jonas F.; Richter, James M.; Chan, Andrew T.; Khalili, Hamed

doi:10.1038/s41395-018-0267-5

Cited by 16 publications

(10 citation statements)

References 37 publications

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“…A similar strategy has been used in other prospective cohort studies in the United States. [17][18][19] Date of diagnosis was defined as date of the first colorectal biopsy demonstrating microscopic colitis. Our method of identifying cases of microscopic colitis has previously been validated with a positive predictive value of 95% when compared with a clinical diagnosis obtained from review of medical records.…”

Section: Study Populationmentioning

confidence: 99%

Microscopic Colitis and Risk of Inflammatory Bowel Disease in a Nationwide Cohort Study

et al. 2020

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BACKGROUND & AIMS: Microscopic colitis shares pathogenetic mechanisms with inflammatory bowel disease (IBD). We studied the association between microscopic colitis and risk of incident IBD using data from a nationwide cohort study. METHODS: We conducted a prospective cohort study of all adults who received a diagnosis of microscopic colitis from 1990 through 2017 in Sweden and risk of incident IBD. Cases of microscopic colitis (n¼ 13,957) were identified through Systematized Nomenclature of Medicine codes from the ESPRESSO (Epidemiology Strengthened by histoPathology Reports in Sweden) study, which included gastrointestinal pathology reports from all of Sweden's 28 centers. Individuals with microscopic colitis were matched to 5 general population controls (n ¼ 66,820) and to unaffected siblings (n ¼13,943). Cox regression was used to estimate adjusted hazard ratio (aHRs) and 95% confidence intervals (CIs). RESULTS: Through December of 2017, we identified 323 incident cases of ulcerative colitis (UC) and 108 incident cases of Crohn's disease (CD) in patients with microscopic colitis compared with 94 UC and 42 CD cases in population comparators. Mean times from diagnosis of microscopic colitis to diagnosis of CD was 3.3 ± 3.2 years and to diagnosis of UC was 3.2 ± 3.5 years. In multivariable models, microscopic colitis was associated with an aHR of 12.6 (95% CI 8.8-18.1) for CD, 17.3 (95% CI 13.7-21.8) for UC, and 16.8 (95% CI 13.9-20.3) for IBD. The 10-year absolute excess risks of CD and UC were 0.9 (95% CI 0.7-1.1) and 2.6 (95% CI 2.2-2.9) percentage points, respectively. In sensitivity analyses, comparing patients with microscopic colitis with their unaffected siblings, the aHRs of CD and UC were 5.4 (95% CI 3.2-9.2) and 9.4 (95% CI 6.4-13.8), respectively. CONCLU-SIONS: In a population-based study in Sweden, we found a significant increase in risk of incident IBD among patients with microscopic colitis. Future studies should focus on potential mechanisms underlying these observed associations.

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Section: Study Populationmentioning

confidence: 99%

Microscopic Colitis and Risk of Inflammatory Bowel Disease in a Nationwide Cohort Study

et al. 2020

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“…The mean body mass index was 25.6 (6.4 SD) for cases and 29.1 (7.0 SD) for controls. Celiac disease has been associated with microscopic colitis (12,13). We asked cases and controls if they had a history of celiac disease and confirmed results by review of the medical record.…”

Section: Resultsmentioning

confidence: 99%

Intraepithelial and lamina propria lymphocytes do not correlate with symptoms or exposures in microscopic colitis

Sandler

Hansen

Peery

et al. 2022

Clin Transl Gastroenterol

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INTRODUCTION:Microscopic colitis, a common cause of diarrhea, is characterized by a largely normal appearance of the mucosa but increased numbers of lymphocytes in the epithelium and lamina propria on microscopy. We sought to determine whether T-cell percentage was associated with exposures or symptoms.METHODS:We conducted a case-control study that enrolled patients referred for colonoscopy for diarrhea. Patients were classified as microscopic colitis cases or controls by an experienced pathologist. Participants provided information on symptoms and exposures during a telephone or internet survey. Research biopsies from the ascending colon and descending colon were examined using immunofluorescence stains for CD3, CD8, and FOXP3 to determine percent T cells per total epithelial or lamina propria cells. Digital images were analyzed by regions of interest using Tissue Studio.RESULTS:There were 97 microscopic colitis cases and 165 diarrhea controls. There was no association between demographic factors and percentage of intraepithelial or lamina propria T cells. In cases, the mean percent T cells were similar in the right colon and left colon. There was no association between mean percent T cells and stool frequency or consistency. There was no association with irritable bowel syndrome, abdominal pain, or medications purported to cause microscopic colitis.DISCUSSION:The lack of association between the density of T cells and medications raises further doubts about their role in disease etiology. Loose and frequent stools in patients with microscopic colitis are not correlated with T-cell density.

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“…14 Similar studies using the same procedures were published previously. 15 Briefly, energy and basic nutrient composition values were assigned for each item and the intake frequency in the dietary survey. For example, intake of a banana (100 gm medium size) once weekly on the survey received an intake value of 12.46 kcal and 50.12 mg potassium, 0.14 mg sodium and 0.7 mg calcium from the banana.…”

Section: Methodsmentioning

confidence: 99%

Dietary Risk Factors for Pediatric Kidney Stones: A Case-Control Study

et al. 2022

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Purpose: Data are scarce regarding dietary risk factors for pediatric nephrolithiasis. Our objective was to perform a case-control study (nonmatched) of the association of dietary nutrients with pediatric urolithiasis. Materials and Methods: We obtained dietary information from pediatric urolithiasis patients (from stone clinic in 2013e2016) and healthy controls (wellchild visit at primary care in 2011e2012). Survey results were converted to standard nutrient intakes. Children younger than 5 years of age and those with extreme calorie intake values (<500 or >5,000 kcal/day) were excluded. The association of individual nutrients with urolithiasis was assessed by bivariate analysis results and machine-learning methods. A multivariable logistic regression model was fitted using urolithiasis as the outcome. Results: We included 285 patients (57 stones/228 controls). MeanAESD age was 8.9AE3.6 years (range 5e20). Of the patients 47% were male. After adjusting for age, sex, body mass index (obese/overweight/normal), calorie intake and oxalate, urolithiasis was associated with higher dietary sodium (OR[2.43 [95% CI [1.40e4.84] per quintile increase, p[0.004), calcium (OR[1.73 [95% CI [1.07e3.00] per quintile increase, p[0.034) and beta carotene (OR[2.01 [95% CI[1.06e4.18] per quintile increase, p[0.042), and lower potassium (OR[0.31 [95% CI[0.13e0.63] per quintile increase, p[0.003). Sensitivity analysis was performed by removing oxalate from the model and limiting the sample to patients aged 5e13 years, with similar results. Conclusions: In our cohort, higher dietary intake of calcium, sodium and beta carotene, and lower potassium intake were associated with pediatric urolithiasis. This is the first study using a detailed dietary survey to identify dietary risk factors for pediatric urolithiasis. Further research is warranted to delineate the mechanisms and to generate a lower risk diet profile for pediatric urolithiasis.

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Dietary Gluten Intake and Risk of Microscopic Colitis Among US Women without Celiac Disease: A Prospective Cohort Study

Abstract: Dietary gluten intake during adulthood was not associated with risk of microscopic colitis among women without celiac disease.

Cited by 16 publications

References 37 publications

Microscopic Colitis and Risk of Inflammatory Bowel Disease in a Nationwide Cohort Study

Microscopic Colitis and Risk of Inflammatory Bowel Disease in a Nationwide Cohort Study

Intraepithelial and lamina propria lymphocytes do not correlate with symptoms or exposures in microscopic colitis

Dietary Risk Factors for Pediatric Kidney Stones: A Case-Control Study

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