An Oxford University-led study has found that people with coeliac disease have a heightened risk of developing cardiovascular disease, despite having fewer known risk factors.
It’s unclear what the reasons for this might be, and further research is needed to unearth the drivers behind these associations. However, according to the study authors, this includes the role of a gluten-free diet, which those affected are required to follow to ease symptoms.
Coeliac disease is an autoimmune condition caused by an exaggerated reaction to gluten, a dietary protein found in wheat, barley, and rye.
The condition is more common in women and is typically diagnosed in childhood and adolescence or between the ages of 40 and 60, say the researchers.
To determine whether traditional cardiovascular risk factors might contribute to the link between coeliac disease and a heightened risk of cardiovascular disease (ischaemic heart disease, heart attack, and stroke), the researchers drew on medical data supplied by UK Biobank participants.
The UK Biobank is a population-based study that recruited around half a million 40-69-year-olds from England, Scotland, and Wales between 2006 and 2010.
Of these, 2083 had coeliac disease but no cardiovascular disease when recruited. However, their cardiovascular health was monitored using linked hospital records and death certificates for an average of over 12 years.
Those with coeliac disease were more likely to be women—56% vs 71.5%—and of white ethnicity—95% vs 99%—than those who didn’t have the condition.
During the monitoring period, 40,687 diagnoses of cardiovascular disease were recorded among all the surviving UK Biobank participants.
Some 218 of these incidents were in people with coeliac disease—equivalent to an annual rate of 9 in every 1000 people—compared with an annual rate of 7.4/1000 in those without the condition.
This translates into a 27% heightened risk of cardiovascular disease for people with coeliac disease compared with those who didn’t have it, after accounting for a wide range of potentially influential lifestyle, medical, and cardiovascular disease factors.
Risk seemed to increase the longer a person had been living with their condition – to a 30% increased risk among those who had had coeliac disease for less than 10 years, rising to an increased risk of 34% among those who had had it for 10 or more years.
Yet people with coeliac disease had fewer known risk factors for cardiovascular disease (including overweight or obesity; high systolic blood pressure; a history of smoking; and high cholesterol), being more likely to have a lower BMI and a lower systolic blood pressure.
This is an observational study, and as such, it can’t establish cause and effect. The researchers acknowledge various limitations to their findings, including that cardiovascular disease risk factors were measured at one point in time only.
