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Celiac Disease and Cardiovascular Risk: A Retrospective Case-Control Study
Maria Pina Dore1,2, Sandro Mereu1, Pier Sergio Saba3
1Dipartimento di Medicina, Chirurgia e Farmacia, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy.
Insights
Celiac disease (CD) is associated with a lower risk of cardiovascular disease (CVD) and carotid lesions. A long-term gluten-free diet (GFD) further reduces CVD risk in celiac patients.
Area of Science:
- Cardiology
- Gastroenterology
- Epidemiology
Background:
- The link between celiac disease (CD) and premature atherosclerosis, including carotid artery intima-media thickness and cardiovascular disease (CVD), remains debated.
- Previous studies have yielded controversial findings regarding the association between CD and CVD risk.
Purpose of the Study:
- To investigate the relationship between celiac disease and the risk of cardiovascular disease.
- To determine if a gluten-free diet (GFD) influences cardiovascular outcomes in patients with CD.
Main Methods:
- Retrospective analysis of clinical records from 8495 patients in Northern Sardinia.
- Logistic regression analysis was used to calculate odds ratios (ORs) for CVD, adjusting for established risk factors and H. pylori infection.
Main Results:
- Celiac disease was diagnosed in 632 patients, and cardiovascular disease in 2504.
- Patients with CD exhibited a significantly reduced risk of CVD (OR 0.30, 95% CI 0.22-0.41).
- Longer duration of GFD correlated with lower CVD risk; CD also decreased carotid plaque frequency (11.8% vs. 40.1%, p < 0.001).
Conclusions:
- Celiac disease is associated with a reduced risk of general CVD and specifically carotid lesions, even after adjusting for confounders.
- Adherence to a gluten-free diet for an extended period further mitigates cardiovascular risk in individuals with celiac disease.
Background:
The association of celiac disease (CD) with premature atherosclerosis, including increased carotid artery intima-media thickness and cardiovascular disease (CVD), is controversial. The aim of this study was to investigate this relationship.
Methods:
Clinical records of patients from Northern Sardinia referred to the Gastroenterology section of the Department of Medicine, University of Sassari, Italy, were analyzed. Unadjusted and adjusted odds ratios (ORs) for CVD with their 95% confidence intervals (CIs) were calculated according to established risk factors, including age, sex, diabetes, dyslipidemia, overweight/obesity, blood hypertension, and cigarette smoking, as well as a possible risk factor such as H. pylori infection.
Results:
In a total of 8495 patients (mean age 52.1 ± 17.3 years; 64.7% females), 2504 reported a diagnosis of CVD and 632 of CD. Logistic regression analysis showed a significantly reduced risk of CVD among patients with CD (OR 0.30, 95% CI 0.22-0.41). Moreover, the long duration of the gluten-free diet (GFD) was able to lower the risk of CVD in celiac patients. Finally, CD significantly decreased the frequency of carotid plaques (11.8% vs. 40.1%, p < 0.001).
Conclusions:
Our retrospective study demonstrated that CD reduces the risk of CVD in general and more specifically of carotid lesions after adjusting for potential confounders, especially in those on GFD for a long time.
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