Study Shows Increased IBD Risk for Celiac Patients, and Vice Versa

Celiac.com 05/15/2020 - The opinions of researchers are currently divided over the connection between celiac disease and inflammatory bowel diseases (IBD). A team of researchers recently set out to to assess evidence for an association between celiac disease and IBD, using a systematic review and meta-analysis. The research team included Maria Ines Pinto-Sanchez, Caroline L. Seiler, Nancy Santesso, Armin Alaedini, Carol Semrad, Anne R. Lee, Premysl Bercik, Benjamin Lebwohl, Daniel A. Leffler, Ciaran P. Kelly, Paul Moayyedi, Peter H. Green, and Elena F. Verdu.

They are variously affiliated with the Department of Medicine, Farncombe Family Digestive Research Institute, McMaster University, Hamilton, Ontario, Canada; the Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Canada; the Celiac Disease Center at Columbia University, New York, New York; the Celiac Disease Center at University of Chicago Medicine, Chicago, Illinois; and the Department of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

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The team scoured medical databases including MEDLINE, EMBASE, CENTRAL, Web of Science, CINAHL, DARE, and SIGLE through June 25, 2019. They looked specifically for studies that determined celiac disease risk in patients with IBD, and IBD in patients with celiac disease, compared with controls of any type. 

To assess bias risk, they used the Newcastle-Ottawa Scale, and GRADE to calculate the certainty level of the evidence. They found nearly 10,000 studies, and included 65 studies in their assessment. Compared with control subjects, moderate certainty evidence revealed that patients with IBD had an increased risk of celiac disease, while celiac disease patients also had an increased risk for IBD. 

Compared with control subjects, low-certainty evidence showed that celiac disease patients have a higher risk of anti-Saccharomyces antibodies, a serologic marker of IBD,

There was also low certainty evidence for no difference in risk of HLA-DQ2 or DQ8 in patients with IBD, compared with control subjects, and very low certainty evidence for an increased risk of anti-tissue transglutaminase in patients with IBD, compared with control subjects. 

The results showed that IBD patients had a slightly lower risk of anti-endomysial antibodies, compared with control subjects, but these results are not certain.

The team's systematic review and meta-analysis showed that celiac patients have an increased risk of IBD, and IBD patients have an increased risk of celiac disease, compared with controls subjects. 

The team is calling for high-quality prospective cohort studies to calculate levels of celiac disease-specific and IBD-specific biomarkers in patients with IBD and celiac disease.

Certainly, the idea that IBD and celiac disease may be connected in some way does not seem far fetched. Stay tuned for more on this and other issues.

Read more at gastrojournal.org