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Coeliac disease and risk of tuberculosis: a population based cohort study
Background: Coeliac disease (CD) is an autoimmune disease often characterised by malnutrition and linked to a number of complications such as an increased risk of lymphoma, adverse pregnancy outcome, and other autoimmune diseases. Tuberculosis (TB) affects a large proportion of the world population...
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| Published in: | Thorax 2007-01, Vol.62 (1), p.23-28 |
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| container_title | Thorax |
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| creator | Ludvigsson, J F Wahlstrom, J Grunewald, J Ekbom, A Montgomery, S M |
| description | Background: Coeliac disease (CD) is an autoimmune disease often characterised by malnutrition and linked to a number of complications such as an increased risk of lymphoma, adverse pregnancy outcome, and other autoimmune diseases. Tuberculosis (TB) affects a large proportion of the world population and is more common in individuals with malnutrition. We investigated the risk of TB in 14 335 individuals with CD and 69 888 matched reference individuals in a general population based cohort study. Methods: Cox proportional hazards method was used to calculate the risk of subsequent TB in individuals with CD. In a separate analysis, the risk of CD in individuals with prior TB was calculated using conditional logistic regression. Results: CD was associated with an increased risk of subsequent TB (hazard ratio (HR) 3.74, 95% CI 2.14 to 6.53; p |
| doi_str_mv | 10.1136/thx.2006.059451 |
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| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_573360</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4026856341</sourcerecordid><originalsourceid>FETCH-LOGICAL-b627t-4a1fa164a0ee736b7d01e6ef287bc49b085ce435811dc1806492140cde2d2ff13</originalsourceid><addsrcrecordid>eNqF0s9vFCEUB_CJ0di1evZmJjF60Mz2PWCA8WDSrlprWr3UXgnDMF12Z4cVZrT972Wzm_4wMT0QCHwgD_hm2UuEKSLlB8P8akoA-BTKipX4KJsg47KgpOKPswkAg4JTwfeyZzEuAEAiiqfZHgpgAqtqkp3MvO2cNnnjotXR5rpv8uDiMvdtPoy1DWbsfHTxQ67ztV-PnR6c7_M62SY3fu7DkMdhbK6fZ09a3UX7YtfvZz-_fD6ffS1OfxyfzA5Pi5oTMRRMY6uRMw3WCspr0QBablsiRW1YVYMsjWW0TJU2BiVwVhFkYBpLGtK2SPezYntu_GPXY63Wwa10uFZeO7WbWqaRVaWglEPy7__rP7mLQ-XDZWqjoiVs9MetTnRlG2P7Ieju3qb7K72bq0v_WxFEJHJT3tvdAcH_Gm0c1MpFY7tO99aPUXGZ_kNW8CAkwEFSFAm-_gcu_Bj69MYKhUSRnhVlUgdbZYKPMdj2pmYEtcmKSllRm6yobVbSjld3r3rrd-FI4M0O6Gh01wbdGxdvnaRcMnrnR1wc7NXNug5LxQUVpfp-MVNn5Ojo7Px4pr4l_27r69XiwSr_AvjC5HQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1781762718</pqid></control><display><type>article</type><title>Coeliac disease and risk of tuberculosis: a population based cohort study</title><source>PubMed Central</source><creator>Ludvigsson, J F ; Wahlstrom, J ; Grunewald, J ; Ekbom, A ; Montgomery, S M</creator><creatorcontrib>Ludvigsson, J F ; Wahlstrom, J ; Grunewald, J ; Ekbom, A ; Montgomery, S M</creatorcontrib><description>Background: Coeliac disease (CD) is an autoimmune disease often characterised by malnutrition and linked to a number of complications such as an increased risk of lymphoma, adverse pregnancy outcome, and other autoimmune diseases. Tuberculosis (TB) affects a large proportion of the world population and is more common in individuals with malnutrition. We investigated the risk of TB in 14 335 individuals with CD and 69 888 matched reference individuals in a general population based cohort study. Methods: Cox proportional hazards method was used to calculate the risk of subsequent TB in individuals with CD. In a separate analysis, the risk of CD in individuals with prior TB was calculated using conditional logistic regression. Results: CD was associated with an increased risk of subsequent TB (hazard ratio (HR) 3.74, 95% CI 2.14 to 6.53; p<0.001). Similar risk estimates were seen when the population was stratified for sex and age at CD diagnosis. Individuals with CD were also at increased risk of TB diagnosed in departments of pulmonary medicine, infectious diseases, paediatrics, or thoracic medicine (HR 4.76, 95% CI 2.23 to 10.16; p<0.001). The odds ratio for CD in individuals with prior TB was 2.50 (95% CI 1.75 to 3.55; p<0.001). Conclusions: CD is associated with TB. This may be due to malabsorption and lack of vitamin D in persons with CD. Individuals with TB and gastrointestinal symptoms should be investigated for CD.</description><identifier>ISSN: 0040-6376</identifier><identifier>ISSN: 1468-3296</identifier><identifier>EISSN: 1468-3296</identifier><identifier>DOI: 10.1136/thx.2006.059451</identifier><identifier>PMID: 17047199</identifier><identifier>CODEN: THORA7</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Thoracic Society</publisher><subject>Abdomen ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens ; autoimmunity ; Bacterial diseases ; Biological and medical sciences ; Celiac disease ; Celiac Disease - complications ; Celiac Disease - epidemiology ; Celiac Disease/complications/epidemiology ; Child ; Child, Preschool ; Codes ; coeliac disease ; Cohort Studies ; cohort study ; Epidemiologi ; Epidemiology ; Female ; Folkhälsomedicinska forskningsområden ; Gastroenterology. Liver. Pancreas. Abdomen ; General aspects ; Gluten ; Granulomas ; Hospitals ; Human bacterial diseases ; Humans ; IFN ; Infant ; Infections ; Infectious diseases ; interferon ; Lymphocytes ; Male ; Medical sciences ; MEDICIN ; MEDICINE ; Middle Aged ; Mycobacterium ; Other diseases. Semiology ; Peptides ; Pneumology ; Population ; Public health medicine research areas ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Regression Analysis ; Risk Factors ; Sarcoidosis ; SEI ; Social medicine ; Socialmedicin ; Socioeconomic Factors ; socioeconomic index ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Sweden - epidemiology ; Tuberculosis ; Tuberculosis and atypical mycobacterial infections ; Tuberculosis, Pulmonary - complications ; Tuberculosis, Pulmonary - epidemiology</subject><ispartof>Thorax, 2007-01, Vol.62 (1), p.23-28</ispartof><rights>Copyright 2007 Thorax</rights><rights>2007 INIST-CNRS</rights><rights>Copyright: 2007 Copyright 2007 Thorax</rights><rights>Copyright © 2007 BMJ Publishing Group Ltd and British Thoracic Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b627t-4a1fa164a0ee736b7d01e6ef287bc49b085ce435811dc1806492140cde2d2ff13</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2111281/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2111281/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,4022,27922,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18368431$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17047199$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-3500$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:14498213$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Ludvigsson, J F</creatorcontrib><creatorcontrib>Wahlstrom, J</creatorcontrib><creatorcontrib>Grunewald, J</creatorcontrib><creatorcontrib>Ekbom, A</creatorcontrib><creatorcontrib>Montgomery, S M</creatorcontrib><title>Coeliac disease and risk of tuberculosis: a population based cohort study</title><title>Thorax</title><addtitle>Thorax</addtitle><description>Background: Coeliac disease (CD) is an autoimmune disease often characterised by malnutrition and linked to a number of complications such as an increased risk of lymphoma, adverse pregnancy outcome, and other autoimmune diseases. Tuberculosis (TB) affects a large proportion of the world population and is more common in individuals with malnutrition. We investigated the risk of TB in 14 335 individuals with CD and 69 888 matched reference individuals in a general population based cohort study. Methods: Cox proportional hazards method was used to calculate the risk of subsequent TB in individuals with CD. In a separate analysis, the risk of CD in individuals with prior TB was calculated using conditional logistic regression. Results: CD was associated with an increased risk of subsequent TB (hazard ratio (HR) 3.74, 95% CI 2.14 to 6.53; p<0.001). Similar risk estimates were seen when the population was stratified for sex and age at CD diagnosis. Individuals with CD were also at increased risk of TB diagnosed in departments of pulmonary medicine, infectious diseases, paediatrics, or thoracic medicine (HR 4.76, 95% CI 2.23 to 10.16; p<0.001). The odds ratio for CD in individuals with prior TB was 2.50 (95% CI 1.75 to 3.55; p<0.001). Conclusions: CD is associated with TB. This may be due to malabsorption and lack of vitamin D in persons with CD. Individuals with TB and gastrointestinal symptoms should be investigated for CD.</description><subject>Abdomen</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antigens</subject><subject>autoimmunity</subject><subject>Bacterial diseases</subject><subject>Biological and medical sciences</subject><subject>Celiac disease</subject><subject>Celiac Disease - complications</subject><subject>Celiac Disease - epidemiology</subject><subject>Celiac Disease/complications/epidemiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Codes</subject><subject>coeliac disease</subject><subject>Cohort Studies</subject><subject>cohort study</subject><subject>Epidemiologi</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Folkhälsomedicinska forskningsområden</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>General aspects</subject><subject>Gluten</subject><subject>Granulomas</subject><subject>Hospitals</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>IFN</subject><subject>Infant</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>interferon</subject><subject>Lymphocytes</subject><subject>Male</subject><subject>Medical sciences</subject><subject>MEDICIN</subject><subject>MEDICINE</subject><subject>Middle Aged</subject><subject>Mycobacterium</subject><subject>Other diseases. Semiology</subject><subject>Peptides</subject><subject>Pneumology</subject><subject>Population</subject><subject>Public health medicine research areas</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Regression Analysis</subject><subject>Risk Factors</subject><subject>Sarcoidosis</subject><subject>SEI</subject><subject>Social medicine</subject><subject>Socialmedicin</subject><subject>Socioeconomic Factors</subject><subject>socioeconomic index</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Sweden - epidemiology</subject><subject>Tuberculosis</subject><subject>Tuberculosis and atypical mycobacterial infections</subject><subject>Tuberculosis, Pulmonary - complications</subject><subject>Tuberculosis, Pulmonary - epidemiology</subject><issn>0040-6376</issn><issn>1468-3296</issn><issn>1468-3296</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><recordid>eNqF0s9vFCEUB_CJ0di1evZmJjF60Mz2PWCA8WDSrlprWr3UXgnDMF12Z4cVZrT972Wzm_4wMT0QCHwgD_hm2UuEKSLlB8P8akoA-BTKipX4KJsg47KgpOKPswkAg4JTwfeyZzEuAEAiiqfZHgpgAqtqkp3MvO2cNnnjotXR5rpv8uDiMvdtPoy1DWbsfHTxQ67ztV-PnR6c7_M62SY3fu7DkMdhbK6fZ09a3UX7YtfvZz-_fD6ffS1OfxyfzA5Pi5oTMRRMY6uRMw3WCspr0QBablsiRW1YVYMsjWW0TJU2BiVwVhFkYBpLGtK2SPezYntu_GPXY63Wwa10uFZeO7WbWqaRVaWglEPy7__rP7mLQ-XDZWqjoiVs9MetTnRlG2P7Ieju3qb7K72bq0v_WxFEJHJT3tvdAcH_Gm0c1MpFY7tO99aPUXGZ_kNW8CAkwEFSFAm-_gcu_Bj69MYKhUSRnhVlUgdbZYKPMdj2pmYEtcmKSllRm6yobVbSjld3r3rrd-FI4M0O6Gh01wbdGxdvnaRcMnrnR1wc7NXNug5LxQUVpfp-MVNn5Ojo7Px4pr4l_27r69XiwSr_AvjC5HQ</recordid><startdate>200701</startdate><enddate>200701</enddate><creator>Ludvigsson, J F</creator><creator>Wahlstrom, J</creator><creator>Grunewald, J</creator><creator>Ekbom, A</creator><creator>Montgomery, S M</creator><general>BMJ Publishing Group Ltd and British Thoracic Society</general><general>BMJ</general><general>BMJ Publishing Group LTD</general><general>BMJ Group</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7QL</scope><scope>C1K</scope><scope>7X8</scope><scope>5PM</scope><scope>AABEP</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>D91</scope><scope>ZZAVC</scope></search><sort><creationdate>200701</creationdate><title>Coeliac disease and risk of tuberculosis: a population based cohort study</title><author>Ludvigsson, J F ; Wahlstrom, J ; Grunewald, J ; Ekbom, A ; Montgomery, S M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b627t-4a1fa164a0ee736b7d01e6ef287bc49b085ce435811dc1806492140cde2d2ff13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Abdomen</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antigens</topic><topic>autoimmunity</topic><topic>Bacterial diseases</topic><topic>Biological and medical sciences</topic><topic>Celiac disease</topic><topic>Celiac Disease - complications</topic><topic>Celiac Disease - epidemiology</topic><topic>Celiac Disease/complications/epidemiology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Codes</topic><topic>coeliac disease</topic><topic>Cohort Studies</topic><topic>cohort study</topic><topic>Epidemiologi</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Folkhälsomedicinska forskningsområden</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>General aspects</topic><topic>Gluten</topic><topic>Granulomas</topic><topic>Hospitals</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>IFN</topic><topic>Infant</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>interferon</topic><topic>Lymphocytes</topic><topic>Male</topic><topic>Medical sciences</topic><topic>MEDICIN</topic><topic>MEDICINE</topic><topic>Middle Aged</topic><topic>Mycobacterium</topic><topic>Other diseases. Semiology</topic><topic>Peptides</topic><topic>Pneumology</topic><topic>Population</topic><topic>Public health medicine research areas</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Regression Analysis</topic><topic>Risk Factors</topic><topic>Sarcoidosis</topic><topic>SEI</topic><topic>Social medicine</topic><topic>Socialmedicin</topic><topic>Socioeconomic Factors</topic><topic>socioeconomic index</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Sweden - epidemiology</topic><topic>Tuberculosis</topic><topic>Tuberculosis and atypical mycobacterial infections</topic><topic>Tuberculosis, Pulmonary - complications</topic><topic>Tuberculosis, Pulmonary - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ludvigsson, J F</creatorcontrib><creatorcontrib>Wahlstrom, J</creatorcontrib><creatorcontrib>Grunewald, J</creatorcontrib><creatorcontrib>Ekbom, A</creatorcontrib><creatorcontrib>Montgomery, S M</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SWEPUB Örebro universitet full text</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SWEPUB Örebro universitet</collection><collection>SwePub Articles full text</collection><jtitle>Thorax</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ludvigsson, J F</au><au>Wahlstrom, J</au><au>Grunewald, J</au><au>Ekbom, A</au><au>Montgomery, S M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coeliac disease and risk of tuberculosis: a population based cohort study</atitle><jtitle>Thorax</jtitle><addtitle>Thorax</addtitle><date>2007-01</date><risdate>2007</risdate><volume>62</volume><issue>1</issue><spage>23</spage><epage>28</epage><pages>23-28</pages><issn>0040-6376</issn><issn>1468-3296</issn><eissn>1468-3296</eissn><coden>THORA7</coden><abstract>Background: Coeliac disease (CD) is an autoimmune disease often characterised by malnutrition and linked to a number of complications such as an increased risk of lymphoma, adverse pregnancy outcome, and other autoimmune diseases. Tuberculosis (TB) affects a large proportion of the world population and is more common in individuals with malnutrition. We investigated the risk of TB in 14 335 individuals with CD and 69 888 matched reference individuals in a general population based cohort study. Methods: Cox proportional hazards method was used to calculate the risk of subsequent TB in individuals with CD. In a separate analysis, the risk of CD in individuals with prior TB was calculated using conditional logistic regression. Results: CD was associated with an increased risk of subsequent TB (hazard ratio (HR) 3.74, 95% CI 2.14 to 6.53; p<0.001). Similar risk estimates were seen when the population was stratified for sex and age at CD diagnosis. Individuals with CD were also at increased risk of TB diagnosed in departments of pulmonary medicine, infectious diseases, paediatrics, or thoracic medicine (HR 4.76, 95% CI 2.23 to 10.16; p<0.001). The odds ratio for CD in individuals with prior TB was 2.50 (95% CI 1.75 to 3.55; p<0.001). Conclusions: CD is associated with TB. This may be due to malabsorption and lack of vitamin D in persons with CD. Individuals with TB and gastrointestinal symptoms should be investigated for CD.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Thoracic Society</pub><pmid>17047199</pmid><doi>10.1136/thx.2006.059451</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Abdomen Adolescent Adult Aged Aged, 80 and over Antigens autoimmunity Bacterial diseases Biological and medical sciences Celiac disease Celiac Disease - complications Celiac Disease - epidemiology Celiac Disease/complications/epidemiology Child Child, Preschool Codes coeliac disease Cohort Studies cohort study Epidemiologi Epidemiology Female Folkhälsomedicinska forskningsområden Gastroenterology. Liver. Pancreas. Abdomen General aspects Gluten Granulomas Hospitals Human bacterial diseases Humans IFN Infant Infections Infectious diseases interferon Lymphocytes Male Medical sciences MEDICIN MEDICINE Middle Aged Mycobacterium Other diseases. Semiology Peptides Pneumology Population Public health medicine research areas Public health. Hygiene Public health. Hygiene-occupational medicine Regression Analysis Risk Factors Sarcoidosis SEI Social medicine Socialmedicin Socioeconomic Factors socioeconomic index Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Sweden - epidemiology Tuberculosis Tuberculosis and atypical mycobacterial infections Tuberculosis, Pulmonary - complications Tuberculosis, Pulmonary - epidemiology |
| title | Coeliac disease and risk of tuberculosis: a population based cohort study |
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