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Obesity and Cardiovascular Risk in Adults With Celiac Disease

Stein, Adam C. MD; Liao, Chuanhong MS; Paski, Shirley MD; Polonsky, Tamar MD; Semrad, Carol E. MD; Kupfer, Sonia S. MD

Journal of Clinical Gastroenterology: August 2016 - Volume 50 - Issue 7 - p 545–550
doi: 10.1097/MCG.0000000000000422
ALIMENTARY TRACT: Original Articles

Background: Patients with celiac disease (CD) may be at an increased risk of cardiovascular disease (CVD), yet CVD risk factors are not well defined in CD. The validated Framingham Heart Study 10-year general CVD risk score (FRS) that incorporates traditional CVD risk factors including body mass index (BMI) has not been previously studied in CD patients.

Aims: To compare BMI and FRS in CD patients with population-based controls.

Methods: Biopsy-proven CD patients were ascertained retrospectively and data on BMI, systolic blood pressure, hypertension, smoking status, and diabetes were obtained at initial and follow-up visits. FRS was calculated and compared with 4 matched general population non-CD controls from the 2009 to 2010 National Health and Nutrition Examination Survey (NHANES).

Results: Of 258 total CD patients, 38.3% were overweight or obese compared with 69.8% of controls (P<0.001). In total, 174 CD patients met the inclusion criteria for FRS calculation. Of these, the median FRS was lower in CD patients compared with controls (3.9 vs. 4.2; P=0.011). In CD patients, tobacco use was significantly lower (P<0.001), whereas systolic blood pressure was significantly higher (P<0.01) than controls.

Conclusions: Global CVD risk is lower among patients with CD compared with population controls. Lower BMI and tobacco use among CD patients could account for this difference. These results suggest that factors other than those measured by FRS could contribute to the increased risk of CVD in CD observed in some studies.

*University of Chicago Celiac Disease Center

Department of Health Studies, University of Chicago

§Section of Cardiology, University of Chicago, Chicago, IL

Department of Medicine, University of Washington, Seattle, WA

Supported by the University of Chicago Celiac Center.

The authors declare that they have nothing to disclose.

Address correspondence to: Sonia S. Kupfer, MD, Section of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Chicago, 900 East 57th Street, MB#9, Chicago, IL 60637 (e-mail: skupfer@medicine.bsd.uchicago.edu).

Received April 7, 2015

Accepted September 1, 2015

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.