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Predictors of persi...
Predictors of persistent villous atrophy in coeliac disease : a population-based study
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- Lebwohl, B. (författare)
- Dept Med, Celiac Dis Ctr, Columbia Univ Coll Phys & Surg, New York NY, USA.; Dept Med, Clin Epidemiol Unit, Karolinska Univ Hosp, Stockholm, Sweden.;Karolinska Inst, Stockholm, Sweden.
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- Murray, J. A. (författare)
- Dept Med, Celiac Dis Ctr, Columbia Univ Coll Phys & Surg, New York NY, USA; Dept Med, Clin Epidemiol Unit, Karolinska Univ Hosp, Stockholm, Sweden; Karolinska Inst, Stockholm, Sweden
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- Rubio-Tapia, A. (författare)
- Coll Med, Dept Med, Div Gastroenterol & Hepatol, Mayo Clin, Rochester MN, USA
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- Green, P. H. R. (författare)
- Dept Med, Celiac Dis Ctr, Columbia Univ Coll Phys & Surg, New York NY, USA
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- Ludvigsson, Jonas F., 1969- (författare)
- Karolinska Institutet,Region Örebro län,Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden
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Dept Med, Celiac Dis Ctr, Columbia Univ Coll Phys & Surg, New York NY, USA; Dept Med, Clin Epidemiol Unit, Karolinska Univ Hosp, Stockholm, Sweden.;Karolinska Inst, Stockholm, Sweden. Dept Med, Celiac Dis Ctr, Columbia Univ Coll Phys & Surg, New York NY, USA; Dept Med, Clin Epidemiol Unit, Karolinska Univ Hosp, Stockholm, Sweden; Karolinska Inst, Stockholm, Sweden (creator_code:org_t)
- 2014-01-16
- 2014
- Engelska.
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Ingår i: Alimentary Pharmacology and Therapeutics. - : Wiley-Blackwell. - 0269-2813 .- 1365-2036. ; 39:5, s. 488-495
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Abstract
Ämnesord
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- Background: Villous atrophy (VA) with intraepithelial lymphocytosis is the histological hallmark of coeliac disease (CD), but reported rates of mucosal recovery are variable.Aim: To determine the impact of age and other demographic variables on the probability of persistent VA on follow-up biopsy.Methods: We identified patients with VA on duodenal histology at all 28 Swedish pathology departments during the years spanning 1969-2008. We examined age, gender, calendar period, duration of disease and educational attainment to determine predictors of persistent VA.Results: Of 7648 patients with CD who underwent follow-up biopsy, persistent VA was present in 3317 (43%; 95% CI 42-44%). The effect of age on persistent VA varied according to time period; among those biopsied in the years spanning 2000-2008, the prevalence of persistent VA was 31%, and increasing age was associated with increasing rates of persistent VA (17% among those younger than 2years compared to 56% among those 70years). In contrast, persistent VA did not vary widely by age in earlier years. On multivariate analysis (restricted to the calendar period 2000-2008, 2-5years after CD diagnosis), persistent VA was more common among males (OR 1.43; 95% CI 1.07-1.90) and less common among patients with higher educational attainment (OR for college degree vs. <2years of high school 0.52, 95% CI 0.35-0.78).Conclusions: The prevalence of persistent villous atrophy has changed over time, with greater rates of healing in recent years. Social differences in persistent villous atrophy suggest that access and/or education regarding the gluten-free diet impact mucosal healing.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmakologi och toxikologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmacology and Toxicology (hsv//eng)
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