Predictors of persistent villous atrophy in coeliac disease: a population-based study

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Lebwohl, B.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. (author)

Predictors of persistent villous atrophy in coeliac disease : a population-based study

Article/chapterEnglish2014

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2014-01-16
Wiley-Blackwell,2014
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LIBRIS-ID:oai:DiVA.org:oru-56577
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-56577URI
https://doi.org/10.1111/apt.12621DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:128234505URI

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Language:English
Summary in:English

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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.

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Murray, J. A.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 (author)
Rubio-Tapia, A.Coll Med, Dept Med, Div Gastroenterol & Hepatol, Mayo Clin, Rochester MN, USA (author)
Green, P. H. R.Dept Med, Celiac Dis Ctr, Columbia Univ Coll Phys & Surg, New York NY, USA (author)
Ludvigsson, Jonas F.,1969-Karolinska Institutet,Region Örebro län,Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden(Swepub:oru)jsln (author)
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)

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In:Alimentary Pharmacology and Therapeutics: Wiley-Blackwell39:5, s. 488-4950269-28131365-2036

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By the author/editor: Lebwohl, B.; Murray, J. A.; Rubio-Tapia, A.; Green, P. H. R.; Ludvigsson, Jona ...

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