Risks of hospitalization and drug consumption in children and young adults with diagnosed celiac disease and the role of maternal education: a population-based matched birth cohort study

Abstract

BackgroundCeliac disease (CD) may affect healthcare use in children and young adults. Socio-economic factors may act as a confounder or effect modifier. We assessed such hypotheses in a population-based birth cohort of young celiac subjects and references matched by maternal education.MethodsThe cohort included all newborns recorded in the Medical Birth Register of Friuli-Venezia Giulia Region (Italy) between 1989 and 2011. CD incident cases were identified through pathology reports, hospital discharges and copayment exemptions and matched with up to five references by sex, year of birth and maternal education. Cox regression models were used to estimate Hazard Ratios (HRs) for major causes of inpatient diagnosis and drug prescription occurring after diagnosis in CD patients compared to references, stratifying by time of first event and maternal education.ResultsWe identified 1294 CD cases and 5681 references. CD cases had a higher risk of hospital admission for any cause (HR: 2.34; 95 % CI 2.08-2.63) and for all major ICD9-CM categories except obstetric complications, skin and musculoskeletal diseases, and injuries and poisoning. Prescription of all major ATC drug categories, except dermatologicals and genito-urinary medications, was significantly increased in CD subjects. For most outcomes, HRs were highest in the first year after CD diagnosis but remained significant after five or more years. HRs were similar across different categories of maternal education.ConclusionsDiagnosed CD subjects had a higher risk of hospitalization and medication use compared to the general population, even five or more years after diagnosis, with no effect modification of maternal education.Electronic supplementary materialThe online version of this article (doi:10.1186/s12876-015-0415-y) contains supplementary material, which is available to authorized users.

A Review on the Sex Differences in Organ and System Pathology with Alcohol Drinking

“…Previous reports on the more severe progression of chronic ALD and challenges of stopping alcohol abuse in females have been documented previously, suggesting that women are more susceptible to alcohol-related liver disease [41]. One recent study showed that light drinking in females does not produce any significant elevation in ALT or liver injury [42], consistent with the studies in males. Another study on hepatic encephalopathy showed that increased risk for the condition was associated with female sex [43].…”

Insight into the metabolic mechanism of scoparone on biomarkers for inhibiting Yanghuang syndrome

“…YHS patients generally experience liver disease13141516171819202122 as a direct result of disordered liver metabolism. From the histopathological observations, a significant change in the microscopic histology of H&E stained liver sections was detected in the YHS group.…”

Diet and inflammatory bowel disease: The Asian Working Group guidelines

“…A systematic review and meta-analysis showed that current smokers with CD were at increased risk of intestinal resection compared to never smokers (HR 1.27, 95% CI 1.08 to 1.49); however, there was no difference in the need for surgery when former and never smokers were compared (HR 1.11, 95% CI 0.95 to 1.30) [ 187 ]. Another meta-analysis of 33 studies revealed that as compared to non-smokers, smokers had increased odds of flare of disease activity (OR 1.56; 95% CI 1.21–2.01), flare after surgery (OR 1.97; 95% CI 1.36–2.85), need for first surgery (OR 1.68; 95% CI 1.33–2.12), and need for second surgery (OR 2.17; 95% CI 1.63–2.89), and quitting smoking was found to ameliorate this [ 188 ].…”