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Bidirectional relat...
Bidirectional relationship between eating disorders and autoimmune diseases
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- Hedman, Anna (author)
- Karolinska Institutet,Karolinska Inst, Sweden
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- Breithaupt, Lauren (author)
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Psychology, George Mason University, Fairfax VA, USA,Karolinska Inst, Sweden; George Mason Univ, VA 22030 USA
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- Hübel, Christopher (author)
- Karolinska Institutet,Karolinska Inst, Sweden; Kings Coll London, England
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- Thornton, Laura M. (author)
- Department of Psychiatry, University of North Carolina aDepartment of Psychiatry, University of North Carolina, Chapel Hill NC, USAt Chapel Hill, Chapel Hill NC, USA,Univ N Carolina, NC 27599 USA
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- Tillander, Annika (author)
- Linköpings universitet,Statistik och maskininlärning,Filosofiska fakulteten,Karolinska Inst, Sweden
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- Norring, Claes (author)
- Karolinska Institutet,Karolinska Inst, Sweden; Stockholm Cty Council, Sweden
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- Birgegård, Andreas (author)
- Karolinska Institutet,Karolinska Inst, Sweden; Stockholm Cty Council, Sweden
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- Larsson, Henrik, 1975- (author)
- Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Karolinska Inst, Sweden; Orebro Univ, Sweden
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- Ludvigsson, Jonas F., 1969- (author)
- Karolinska Institutet,Karolinska Inst, Sweden; Orebro Univ Hosp, Sweden
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- Sävendahl, Lars (author)
- Karolinska Institutet,Karolinska Inst, Sweden
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- Almqvist, Catarina (author)
- Karolinska Institutet,Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden
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- Bulik, Cynthia M. (author)
- Karolinska Institutet,Karolinska Inst, Sweden; Univ N Carolina, NC 27599 USA; Univ N Carolina, NC 27515 USA
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- ISSN 0021-9630
- 2018-09-03
- 2019
- English.
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In: Journal of Child Psychology and Psychiatry. - Stockholm : Blackwell Publishing. - 0021-9630 .- 1469-7610. ; 60:7, s. 803-812
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Abstract
Subject headings
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- BACKGROUND: Immune system dysfunction may be associated with eating disorders (ED) and could have implications for detection, risk assessment, and treatment of both autoimmune diseases and EDs. However, questions regarding the nature of the relationship between these two disease entities remain. We evaluated the strength of associations for the bidirectional relationships between EDs and autoimmune diseases.METHODS: In this nationwide population-based study, Swedish registers were linked to establish a cohort of more than 2.5 million individuals born in Sweden between January 1, 1979 and December 31, 2005 and followed up until December 2013. Cox proportional hazard regression models were used to investigate: (a) subsequent risk of EDs in individuals with autoimmune diseases; and (b) subsequent risk of autoimmune diseases in individuals with EDs.RESULTS: We observed a strong, bidirectional relationship between the two illness classes indicating that diagnosis in one illness class increased the risk of the other. In women, the diagnoses of autoimmune disease increased subsequent hazards of anorexia nervosa (AN), bulimia nervosa (BN), and other eating disorders (OED). Similarly, AN, BN, and OED increased subsequent hazards of autoimmune diseases.Gastrointestinal-related autoimmune diseases such as, celiac disease and Crohn's disease showed a bidirectional relationship with AN and OED. Psoriasis showed a bidirectional relationship with OED. The previous occurence of type 1 diabetes increased the risk for AN, BN, and OED. In men, we did not observe a bidirectional pattern, but prior autoimmune arthritis increased the risk for OED.CONCLUSIONS: The interactions between EDs and autoimmune diseases support the previously reported associations. The bidirectional risk pattern observed in women suggests either a shared mechanism or a third mediating variable contributing to the association of these illnesses.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Psykiatri (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Psychiatry (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Arbetsmedicin och miljömedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Occupational Health and Environmental Health (hsv//eng)
Keyword
- anorexia nervosa
- autoimmunity
- bulimia nervosa
- cox regression
- hazard
- immune system
- risk
Publication and Content Type
- ref (subject category)
- art (subject category)
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Hedman, Anna
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Breithaupt, Laur ...
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Hübel, Christoph ...
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Thornton, Laura ...
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Tillander, Annik ...
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Norring, Claes
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Birgegård, Andre ...
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Larsson, Henrik, ...
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Ludvigsson, Jona ...
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Sävendahl, Lars
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Almqvist, Catari ...
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Bulik, Cynthia M ...
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Örebro University
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Karolinska Institutet
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Linköping University