Emilsson Louise, Abdul Sultan Alyshah, Ludvigsson Jonas F
Primary Care Research Unit, Vårdcentralen Värmlands Nysäter, Värmland County, Sweden; Department of Health Management and Health Economy, Institute of Health and Society, University of Oslo, Norway.
Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK; National Institute of Health Research Nottingham Digestive Diseases Centre Biomedical Research Unit, Nottingham University Hospital NHS Trust and University of Nottingham, Nottingham, UK.
Dig Liver Dis. 2016 Apr;48(4):376-80. doi: 10.1016/j.dld.2015.11.016. Epub 2015 Nov 29.
Several studies have shown an excess mortality in individuals with celiac disease (CD). However, it is unknown if also first-degree relatives (FDRs) to celiac patients are at increased risk of death.
We aimed to assess mortality in FDRs to celiac patients.
Individuals with CD were identified through biopsy reports (equal to Marsh grade III). Each celiac individual was matched on sex, age, county and calendar year with up to five control individuals. Through Swedish healthcare registries we identified all FDRs (father, mother, sibling, offspring) of CD individuals and controls. Through Cox regression we calculated hazard ratios (HRs) for mortality (all-cause death, circulatory, cancer and other).
We identified 109,309 FDRs of celiac individuals and 549,098 FDRs of controls. Overall mortality was increased in FDRs to celiac individuals (HR=1.02, 95%CI=1.00-1.04, p=0.03). This corresponded to an excess risk of 5.9 deaths per 100,000 person-years of follow-up. When limiting follow-up to time since celiac diagnosis in the index individual, we found no increased risk of death (HR=1.01; 95%CI=0.98-1.03).
FDRs to individuals with CD are at increased risk of death. This excess risk is however minimal and unlikely to be of any clinical importance to the individual.
多项研究表明，患有乳糜泻（CD）的个体死亡率过高。然而，乳糜泻患者的一级亲属（FDRs）是否也面临更高的死亡风险尚不清楚。
我们旨在评估乳糜泻患者的一级亲属的死亡率。
通过活检报告（相当于马什III级）确定患有CD的个体。每位乳糜泻患者在性别、年龄、县和历年方面与多达五名对照个体进行匹配。通过瑞典医疗保健登记处，我们确定了CD个体和对照个体的所有一级亲属（父亲、母亲、兄弟姐妹、子女）。通过Cox回归，我们计算了死亡率（全因死亡、循环系统疾病、癌症和其他疾病）的风险比（HRs）。
我们确定了109309名乳糜泻患者的一级亲属和549098名对照个体的一级亲属。乳糜泻患者的一级亲属的总体死亡率有所增加（HR=1.02，95%CI=1.00-1.04，p=0.03）。这相当于每10万人年的随访中有5.9例额外死亡风险。当将随访限制在索引个体确诊乳糜泻后的时间时，我们发现死亡风险没有增加（HR=1.01；95%CI=0.98-1.03）。
乳糜泻患者的一级亲属死亡风险增加。然而，这种额外风险极小，对个体而言不太可能具有任何临床意义。
