Difference in Celiac Disease Risk Between Swedish Birth Cohorts Suggests an Opportunity for Primary Prevention

Olsson, Cecilia; Hernell, Olle; Hörnell, Agneta; Lönnberg, Göran; Ivarsson, Anneli

doi:10.1542/peds.2007-2989

Cited by 58 publications

(68 citation statements)

References 30 publications

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“…Incidence in epoch 4 is also comparable to that reported in Finland (12.3/100 000) 20 but still much lower than that in Sweden (44/100 000). 10 Buchanan et al 21 observed a similar rise in numbers in the west of Scotland from 1995 to 2008. Therefore, we suspect that the rising trend in incidence applies to Scotland as a whole; however, we cannot be certain that this is the case in relation to classic cases.…”

Section: Discussionmentioning

confidence: 81%

“…5 Similar trends have been observed in Europe and North America over comparable time periods. [6][7][8][9][10] A number of articles also report that a greater proportion of children in more recent years are diagnosed through targeted screening and experience fewer GI symptoms. [7][8][9] However, no report has calculated the incidence of cases diagnosed over time because of a lower threshold to test or on the basis of the well-established classic presentation.…”

Section: (Continued On Last Page)mentioning

confidence: 99%

“…28 Infant feeding practices have been implicated in CD development. 10,29,30 A meta-analysis revealed a 52% reduction in CD risk in children breastfed at time of gluten introduction compared with those not breastfed at this time. 29 It is hypothesized that immune mediating factors in breast milk, such as immunoglobulin A antibodies, lactoferrin, and lysozyme, may protect against GI infections that could play a role in the increased gut permeability in CD.…”

Section: Figurementioning

confidence: 99%

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The Rising Incidence of Celiac Disease in Scotland

et al. 2013

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BACKGROUND AND OBJECTIVES: Although the incidence of pediatric celiac disease (CD) is increasing globally, it is uncertain whether this is attributed to improved case ascertainment or signifies a true rise. We aimed to identify all incident cases of childhood CD in southeast Scotland over the period 1990 to 2009 to assess trends in total incidence and cases diagnosed as a result of (1) a classic presentation, (2) a nonclassic presentation, or (3) targeted screening. METHODS: Twenty-year retrospective cohort study of case notes, pathology databases, endoscopy, and patient records for all children (<16 years of age) diagnosed with CD on biopsy in southeast Scotland (at-risk population of 225 000–233 000). Data were age-gender standardized and Poisson regression models used to calculate changes in incidence over time. RESULTS: A total of 266 children were diagnosed from 1990 to 2009 with an increase in incidence from 1.8/100 000 (95% confidence interval [CI] 1.1–2.7) to 11.7/100 000 (95% CI 9.8–13.9) between the epochs 1990 to 1994 and 2005 to 2009, respectively (P < .0001). The incidence of nonclassic presentation (children with a monosymptomatic presentation and those with extraintestinal symptoms) and actively screened cases increased by 1566% (P < .05) and 1170% (P < .001) from 1990 to 1999 to 2000 to 2009, respectively. However, a rise in the incidence of Oslo classic cases from 1.51/100 000 (95% CI 0.91–2.38) in 1990 to 1994 to 5.22/100 000 (95% CI 3.98–6.75) in 2005 to 2009 (P < .01) remained evident. CONCLUSIONS: The incidence of pediatric CD increased 6.4-fold over the 20 years. This study demonstrates that this rise is significant for classic CD, indicating a true rise in the incidence of pediatric CD.

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Section: Discussionmentioning

confidence: 81%

Section: (Continued On Last Page)mentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

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The Rising Incidence of Celiac Disease in Scotland

et al. 2013

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“…According to the latest guidelines, gluten should be introduced into the diet of infants 4-6 months old, but no particular quantity is recommended. Studies have claimed that infant feeding practices, especially breastfeeding and timing of gluten introduction, may delay the onset of the disease or modify its symptoms (5)(6)(7)(8)(9)(10). In addition, they have suggested that breastfeeding at the time of gluten introduction can protect against celiac disease.…”

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confidence: 99%

Influence of Early Feeding Practices on Celiac Disease in Infants

et al. 2010

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“…During 2000-2010, the incidence rate of clinically detected cases of celiac disease in children in South-Eastern Norway has increased from 16 to 44/100.000/person-years (K. Størdal et al, unpublished observation). Sweden has experienced an epidemic with cohort effects on cumulative incidence (24). Such rapid changes cannot be explained by changes in the genetic composition of the population.…”

Section: Early Environmental Factors In Celiac Disease and Type 1 Diamentioning

confidence: 99%

Prediction of autoimmune diabetes and celiac disease in childhood by genes and perinatal environment: Design and initial aims of the PAGE study

Stene¹,

Joner²,

Størdal³

2014

Nor J Epidemiol

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Type 1 diabetes and celiac disease result from misdirected immune mediated destruction of host cells, and are among the most common chronic diseases in children. Despite changes in incidence over the past 3 decades, little is known about non-genetic risk factors (except for dietary gluten for celiac disease). Norway is among the countries in the world with the highest incidence of these two diseases. We describe here plans and study design for the PAGE study (Prediction of Autoimmune diabetes and celiac disease in childhood by Genes and perinatal Environment). PAGE is a sub-study within the Norwegian Mother and Child Cohort study, including follow-up of more than 100,000 pregnancies. Children who develop type 1 diabetes or celiac disease are identified via linkage to the Norwegian Patient Register and the Norwegian Childhood Diabetes Registry, with complementing information from questionnaires. The overall aim is to test hypotheses about potential non-genetic risk factors for type 1 diabetes and for celiac disease, with focus on factors operating early in life. In addition to a full cohort analysis of factors registered in questionnaires, we will analyse biomarkers in maternal blood plasma and cord blood plasma. Mothers and children will be genotyped for well-established susceptibility polymorphisms. Biomarkers will be analysed in cases and controls within the cohort. Factors to be tested in the full cohort include infant feeding, diet and dietary supplements in the mother during pregnancy and in the child, and use of antibiotics and non-prescription drugs. Biomarkers to be tested include 25-hydroxyvitamin D, markers of immune activation, and small metabolites (metabolomics). We will also explore the potential role of maternal cells in the fetal circulation (maternal microchimerism) in later risk of celiac disease and type 1 diabetes.This is an open access article distributed under the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Difference in Celiac Disease Risk Between Swedish Birth Cohorts Suggests an Opportunity for Primary Prevention

Cited by 58 publications

References 30 publications

The Rising Incidence of Celiac Disease in Scotland

The Rising Incidence of Celiac Disease in Scotland

Influence of Early Feeding Practices on Celiac Disease in Infants

Prediction of autoimmune diabetes and celiac disease in childhood by genes and perinatal environment: Design and initial aims of the PAGE study

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