Obesity and Cardiovascular Risk in Adults With Celiac Disease
Adam C Stein1, Chuanhong Liao, Shirley Paski
1*University of Chicago Celiac Disease Center †Department of Health Studies, University of Chicago §Section of Cardiology, University of Chicago, Chicago, IL ‡Department of Medicine, University of Washington, Seattle, WA.
Insights
Patients with celiac disease (CD) have a lower cardiovascular disease (CVD) risk score compared to controls, likely due to lower body mass index (BMI) and less tobacco use. This suggests other factors may contribute to CVD risk in CD.
Area of Science:
- Cardiology
- Gastroenterology
- Public Health
Background:
- Celiac disease (CD) patients may face higher cardiovascular disease (CVD) risks.
- Traditional CVD risk factors are not well-defined in CD.
- The Framingham Heart Study 10-year general CVD risk score (FRS) has not been evaluated in CD.
Purpose of the Study:
- To compare body mass index (BMI) and FRS in CD patients versus population controls.
- To investigate CVD risk factors in celiac disease.
- To assess the applicability of FRS in CD patient populations.
Main Methods:
- Retrospective analysis of biopsy-proven CD patients.
- Data collection included BMI, blood pressure, smoking, and diabetes.
- FRS calculation and comparison with matched National Health and Nutrition Examination Survey (NHANES) controls.
Main Results:
- CD patients had lower rates of overweight/obesity (38.3% vs. 69.8%) and lower median FRS (3.9 vs. 4.2).
- CD patients exhibited significantly lower tobacco use (P<0.001).
- CD patients showed significantly higher systolic blood pressure (P<0.01) compared to controls.
Conclusions:
- Global CVD risk appears lower in CD patients than in population controls.
- Reduced BMI and tobacco use in CD patients may explain the lower observed CVD risk.
- Factors beyond FRS may underlie the increased CVD risk noted in some CD studies.
Background:
Patients with celiac disease (CD) may be at an increased risk of cardiovascular disease (CVD), yet CVD risk factors are not well defined in CD. The validated Framingham Heart Study 10-year general CVD risk score (FRS) that incorporates traditional CVD risk factors including body mass index (BMI) has not been previously studied in CD patients.
Aims:
To compare BMI and FRS in CD patients with population-based controls.
Methods:
Biopsy-proven CD patients were ascertained retrospectively and data on BMI, systolic blood pressure, hypertension, smoking status, and diabetes were obtained at initial and follow-up visits. FRS was calculated and compared with 4 matched general population non-CD controls from the 2009 to 2010 National Health and Nutrition Examination Survey (NHANES).
Results:
Of 258 total CD patients, 38.3% were overweight or obese compared with 69.8% of controls (P<0.001). In total, 174 CD patients met the inclusion criteria for FRS calculation. Of these, the median FRS was lower in CD patients compared with controls (3.9 vs. 4.2; P=0.011). In CD patients, tobacco use was significantly lower (P<0.001), whereas systolic blood pressure was significantly higher (P<0.01) than controls.
Conclusions:
Global CVD risk is lower among patients with CD compared with population controls. Lower BMI and tobacco use among CD patients could account for this difference. These results suggest that factors other than those measured by FRS could contribute to the increased risk of CVD in CD observed in some studies.
Related Concept Videos
01:24Obesity
01:30Coronary Artery Disease I: Introduction
01:25Pharmacokinetics in Obese Patients: Drug Absorption and Distribution
01:19Overview of Carbohydrate Metabolism
Glucose transport into cells is facilitated by a family of transport proteins called GLUT (Glucose Transporters). GLUT4 is the primary glucose transporter for insulin-stimulated glucose...
01:15Diabetes: Symptoms, Diagnosis, and Complications
01:27Psychoneuroimmunology: Cardiovascular Disease
A key area of focus in PNI is the relationship between stress and coronary...