Year 2018 / Volume 110 / Number 8
Original
Ten years of follow-up of the Spanish cohort of the European PreventCD study: the lessons learned

493-499

DOI: 10.17235/reed.2018.5324/2017

Paula Crespo Escobar, Gemma Castillejo, Eva Martínez-Ojinaga, Ester Donat, Isabel Polanco, María Luisa Mearin, Carmen Ribes-Koninckx,

Abstract
Aim: to evaluate the influence of gluten consumption on celiac disease development and to describe its natural history in the Spanish cohort of the European PreventCD study. Methods: prospective multi-center double blind study of 225 children that were followed up from birth. All cases were HLA-DQ2/HLA-DQ8 positive with a 1st degree relative with celiac disease and were followed up in three centers from Madrid, Reus and Valencia. Gluten intake was determined between four and ten months according to the protocol. Gluten intake was ad libitum between eleven and 36 months and was prospectively quantified by means of dietary records. Clinical visits and specific antibody analysis for celiac disease were performed periodically. Results: twenty-six cases were diagnosed, all had a positive biopsy and serology; 21 had gastrointestinal symptoms and five were asymptomatic. In addition, 2,565 food records were analyzed and statistically significant differences (p < 0.001) were found with regard to gluten consumption among the three centers, although not between celiac and non-celiac children (p = 0.025). The HLA-DQ2.5/DQ2.5 and DQ2.5/DQ2.2 genotypes had a relative risk of 4.7 (95% CI: 0.80-27.55; p = 0.08), which was higher than for the rest of genotypes. Female gender also had a relative risk that was five times higher than that for males. Conclusions: the amount of gluten intake between 11 and 36 months or the duration of breast feeding were not risk factors for the development of CD in the Spanish population. The HLA genotype and gender were the most relevant associated factors. In this at-risk group, the disease presented before two years of age in the majority of the cases with a weak clinical expression.
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References
1. Gujral N, Freeman HJ, Thomson AB. Celiac disease: prevalence, diagnosis, pathogenesis and treatment. World J Gastroenterol. 2012 Nov 14;18(42):6036-59
2. Ludvigsson JF, Leffler DA, Bai JC, Biagi F, Fasano A, Green PH, et al. The Oslo definitions for coeliac disease and related terms. Gut. 2013 Jan;62(1):43-52
3. Rodrigo Sáez Luis, Fuentes Álvarez D, Pérez Martínez I, Álvarez Mieres N, Niño García P, Francisco García R, et al. Diferencias entre la enfermedad celiaca infantil y del adulto. Rev Esp Enferm Dig. 2011; Vol. 103, n.5:238-244.
4. Margaritte-Jeannin P, Babron MC, Bourgey M, Louka AS, Clot F, Percopo S, et al. HLA-DQ relative risks for coeliac disease in European populations: a study of the European Genetics Cluster on Coeliac Disease. Tissue Antigens. 2004 Jun;63(6):562-7.
5. Catassi C, Gatti S, Lionetti E. World perspective and celiac disease epidemiology. Dig Dis. 2015;33(2):141-6.
6. Singh P, Arora S, Lal S, Strand TA, Makharia GK. Risk of Celiac Disease in the First- and Second-Degree Relatives of Patients With Celiac Disease: A Systematic Review and Meta-Analysis. Am J Gastroenterol 2015; 110:1539–1548.
7. Farré C, Humbert P, Vilar P, Varea V, Aldeguer X, Carnicer J, et al. Serological markers and HLA-DQ2 haplotype among first-degree relatives of celiac patients. Catalonian Coeliac Disease Study Group . Dig Dis Sci 1999; 44 : 2344 – 9.
8. Esteve M, Rosinach M, Fernández-Bañares F, Farré C, Salas A, Alsina M, et al. Spectrum of gluten sensitive enteropathy in first-degree relatives of patients with coeliac disease: clinical relevance of lymphocytic enteritis. Gut 2006; 55: 1739 – 45.
9. Vitoria JC, Arrieta A, Astigarraga I, García-Masdevall D, Rodriguez-Soriano J. Use of serological markers as a screening test in family members of patients with celiac disease. J Pediatr Gastroenterol Nutr 1994; 19: 304 – 9.
10. Cuadrillero Quesada MC, Solís Sánchez G, Parrondo Garrido S, Martinez Mengual L, Menendez Arias C, Martin Fuente E, et al. Case finding study among first degree relatives of coeliac children. Rev Esp Pediat 2004; 60: 278 – 82
11. Vaquero L, Caminero A, Nuñez A, Hernando M, Iglesias C, Casqueiro J, et al. Coeliac disease screening in first degree relatives on the basis of biopsy and genetic risk. Eur J Gastroenterol Hepatol 2014; 26: 263 – 7.
12. Norris JM, Barriga K, Hoffenberg EJ, Taki I, Miao D, Haas JE, et al. Risk of celiac disease autoimmunity and timing of gluten introduction in the diet of infants at increased risk of disease. JAMA 2005;293:2343–51.
13. Akobeng AK, Ramanan AV, Buchan I, Heller RF. Effect of breast feeding on risk of coeliac disease: a systematic review and meta-analysis of observational studies. Arch Dis Child 2006;91:39–44.
14. Ivarsson A, Persson LA, Nyström L, Ascher H, Cavell B, Danielsson L, et al. Epidemic of coeliac disease in Swedish children. Acta Paediatr 2000; 89: 165-171.
15. Ivarsson A, Hernell O, Stenlund H, Persson LA. Breastfeeding protects against celiac disease. Am J Clin Nutr. 2002;75(5):914-21
16. Ivarsson A. The Swedish epidemic of coeliac disease explored using an epidemiological approach--some lessons to be learnt. Best Pract Res Clin Gastroenterol 2005; 19: 425-44
17. Aronsson CA, Lee HS, Liu E, Usitalo U, Hummel S, Yang J, et al. Age at gluten introduction and risk of celiac disease. Pediatrics. 2015 Feb;135(2):239-45
18. Stordal K, White RA, Eggesbo M. Early feeding and risk of celiac disease in a prospective birth cohort. Pediatrics. 2013;132(5):e1202-9
19. Szajewska H, Shamir R, Chmielewska A, Pieścik-Lech M, Auricchio R, Ivarsson A, et al. Systematic review with meta-analysis: early infant feeding and coeliac disease update 2015. Aliment Pharmacol Ther. 2015;41(11):1038-54
20. Vriezinga SL, Auricchio R, Bravi E, Castillejo G, Chmielewska A, Crespo-Escobar P, et al. Randomized Feeding Intervention in Infants at High Risk for Celiac Disease. N Engl J Med 2014;371:1304-15.
21. Lionetti E, Castellaneta S, Francavilla R, Pulvirenti A, Tonutti E, Amarri S, et al. Introduction of gluten, HLA status, and the risk of celiac disease in children. N Engl J Med. 2014 Oct 2;371(14):1295-303
22. Szajewska H, Shamir R, Mearin L, Ribes-Koninckx C, Catassi C, Domellöf M, et al. Gluten Introduction and the Risk of Coeliac Disease: A Position Paper by the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr. 2016; 62(3):507-13
23. Andrén Aronsson C, Lee HS, Koletzko S, Uusitalo U, Yang J, Virtanen SM, et al. Effects of Gluten Intake on Risk of Celiac Disease: a case-control study on a Swedish birth cohort. Clin Gastroenterol Hepatol. 2016;14(3):403-409
24. Hogen Esch CE, Rosén A, Auricchio R, Romanos J, Chmielewska A, Putter H, et al. The PreventCD Study design: towards new strategies for the prevention of coeliac disease. Eur J Gastroenterol Hepatol 2010;22:1424–30
25. Crespo Escobar P, Calvo Lerma J, Hervas Marin D, Donat Aliaga E, Masip Simo E, Polo Miquel B, et al. Development and validation of two food frequency questionnaires to assess gluten intake in children up to 36 months of age. Nutr Hosp. 2015;32(5):2080-2090.
26. Van Overbeek FM, Uil-Dieterman IG, Mol IW, Ko¨hler-Brands L, Heymans HS, Mulder CJ. The daily gluten intake in relatives of patients with coeliac disease compared with that of the general Dutch population. Eur J Gastroenterol Hepatol 1997;9:1097–9.
27. Hopman EG, Kiefte-de Jong JC, le Cessie S, Moll HA, Witteman JC, Bleeker SE, et al. Food questionnaire for assessment of infant gluten consumption. Clin Nutr. 2007 Apr;26(2):264-71
28. Hopman EG, Pruijn R, Tabben EH, le Cessie S, Mearin ML. Food questionnaire for the assessment of gluten intake by children 1 to 4 years old. J Pediatr Gastroenterol Nutr. 2012 Jun;54(6):791-6
29. Husby S, Koletzko S, Korponay-Szabó IR, Mearin ML, Phillips A, Shamir R, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr 2012;54:136-60
30. Liu E, Lee HS, Aronsson CA, Hagopian W, Koletzko S, Rewers M, et al. Risk of Pediatric Celiac Disease According to HLA Haplotype and Country. New England Journal of Medicine. 2014;371(1):42-9.
31. Pietzak MM, Schofield TC, McGinniss MJ, Nakamura RM. Stratifying risk for celiac disease in a large at-risk United States population by using HLA alleles. Clin Gastroenterol Hepatol. 2009 Sep;7(9):966-71
32. Ivarsson A, Persson LA, Nyström L, Hernell O. The Swedish coeliac disease epidemic with a prevailing twofold higher risk in girls compared to boys may reflect gender specific risk factors. Eur J Epidemiol 2003; 18(7): 677-84
33. Mearin ML. Celiac disease among children and adolescents. Curr Probl Pediatr Adolesc Health Care 2007; 37:86-105.
34. Markle JG, Fish EN. SeXX matters in immunity. Trends Immunol 2014; 35:97- 1
35. Lagerqvist C, Dahlbom I, Hansson T, Jidell E, Juto P, Olcén P, et al. Antigliadin immunoglobulin: A best in finding celiac disease in children younger than 18 months of age. J Pediatr Gastroenterol Nutr 2008;47(4):428-35.
36. Naggara O, Raymond J, Guilbert F, Roy D, Weill A, Altman DG. Analysis by categorizing or dichotomizing continuous variables is inadvisable: An example from the natural history of unruptured aneurysms. Am J Neuroradiol 2011. Vol. 32, No. 3; 437-440.
37. Royston P, Altman DG, Sauerbrei W. Dichotomizing continuous predictors in multiple regression: a bad idea. Stat Med 2006, Vol. 25; 127-141.
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Crespo Escobar P, Castillejo G, Martínez-Ojinaga E, Donat E, Polanco I, Mearin M, et all. Ten years of follow-up of the Spanish cohort of the European PreventCD study: the lessons learned. 5324/2017


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Publication history

Received: 19/10/2017

Accepted: 01/02/2018

Online First: 27/04/2018

Published: 30/07/2018

Article revision time: 100 days

Article Online First time: 190 days

Article editing time: 284 days


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