Shared Genetic Factors Involved in Celiac Disease, Type 2 Diabetes and Anorexia Nervosa Suggest Common Molecular Pathways for Chronic Diseases

Mostowy, Joanna; Montén, Caroline; Gudjonsdottir, Audur H.; Arnell, Henrik; Browaldh, Lars; Nilsson, Staffan; Agardh, Daniel; Naluai, Åsa Torinsson

doi:10.1371/journal.pone.0159593

Cited by 15 publications

(9 citation statements)

References 48 publications

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“…The studies have found hazard ratios for the development of celiac disease in those already diagnosed with AN ranging from 2.18 (95% CI [1.45–3.29]) to 3.08 (95% CI [2.11–4.34]) and the development of AN in those previously diagnosed with celiac of 1.46 (95% CI [1.08–1.98]) to 2.46 (95% CI [1.4–4.03]) (Marild et al, 2017; Wotton et al, 2016). One genetic study, by Mostowy et al (2016), also found shared genetic factors between the two diseases.…”

Section: Resultsmentioning

confidence: 98%

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The intersect of gastrointestinal symptoms and malnutrition associated with anorexia nervosa and avoidant/restrictive food intake disorder: Functional or pathophysiologic?—A systematic review

Gibson

Watters

Mehler

2021

Intl J Eating Disorders

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Objective Although multiple pathophysiologic changes develop within the gastrointestinal (GI) system in the setting of malnutrition, the etiology of the reported multitude of symptoms in those with anorexia nervosa and avoidant restrictive intake disorder, as well as their contribution toward disordered eating, remain poorly understood. This systematic review seeks to better understand how these physiologic changes of malnutrition of the esophagus, stomach, intestines, and pancreas contribute toward the reported GI symptoms, as well as better understand how celiac disease, inflammatory bowel disease, pelvic floor dysfunction, and Ehlers–Danlos syndrome contribute toward disordered eating. Methods Studies of any design exploring the pathogenesis of complications and treatment strategies were included. Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guidelines were used to structure and complete the review. Results A total of 146 articles were used for the review. The majority of studies were observational or case reports/case series. Discussion Pathophysiologic changes of the esophagus, stomach, and intestines develop with malnutrition, although these changes do not consistently correlate with expressed GI symptoms in patients with restrictive eating disorders. Celiac disease and inflammatory bowel disease also contribute to disordered eating through the associated somatic GI complaints, while pelvic floor dysfunction and Ehlers–Danlos syndrome contribute through both somatic symptoms and functional symptoms. Indeed, functional GI symptoms remain problematic during the course of treatment, and further research is required to better understand the extent to which these symptoms are functional in nature and remit or remain as treatment ensues.

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Section: Resultsmentioning

confidence: 98%

“…Several studies are indeed suggestive of a bidirectional relationship between celiac disease and AN (Hedman et al, 2019;Marild et al, 2017;Nacinovich et al, 2017;Wotton et al, 2016 (Marild et al, 2017;Wotton et al, 2016). One genetic study, by Mostowy et al (2016), also found shared genetic factors between the two diseases.…”

Section: Celiac Diseasementioning

confidence: 98%

The intersect of gastrointestinal symptoms and malnutrition associated with anorexia nervosa and avoidant/restrictive food intake disorder: Functional or pathophysiologic?—A systematic review

Gibson

Watters

Mehler

2021

Intl J Eating Disorders

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“…Therefore, presence of type 2 diabetes should not be taken as a reason for not screening for celiac disease. There has also been suggestion for screening for celiac disease in type 2 diabetes mellitus 29,30 . Osteoporosis or osteopenia which is also well recognized in celiac disease 31 , was seen in 12% of our patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical Picture of Celiac disease: Experience from a health care provider in Arabia

2020

OJGH

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Background: Most studies describing clinical features and associations of celiac disease come from the studies conducted in the western world. Our aim was to determine the clinical features and associations of Celiac disease from our centre serving a Middle East population in Saudi Arabia. Methods: This retrospective study was conducted in a health care provider serving the Eastern Province of Saudi Arabia. All patients with biopsy-confirmed celiac disease receiving health care at our centre between April 2002 and December 2018 were identified. Individual case records were reviewed. In addition, the Slicer Dicer function was also used from the Electronic medical health record [EPIC] for analysing the clinical features and associations. Results: We analyzed the clinical features of 149 patients with Celiac disease. 66% of these were females. There was progressively increased yield of confirmed Celiac disease over the study period. This was paralleled by an increase in TTG antibody tests performed year by year. 77 (51.6%) patients had gastrointestinal symptoms. 26% of patients had iron deficiency anemia. 24 patients (16%) had diabetes, of which 46% were type 2. 18 (12%) patients had osteoporosis or osteopenia, and 28 (19%) had various skin diseases. Conclusion:In Saudi Arabia, celiac disease is being increasingly recognized, largely because of increased awareness and increasing TTG antibody testing. Many patients present with non-gastrointestinal symptoms. Knowledge about the varied clinical features and the targeted use of celiac serology should lead to even earlier recognition of the disease.

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“…On the other hand, due to shared genetic regions between EDs and autoimmune diseases (Mostowy et al, 2016), some other studies had focused on the prevalence and risk of CD in patients with EDs.…”

Section: Introductionmentioning

confidence: 99%

A systematic review and meta‐analysis of the prevalence and odds of eating disorders in patients with celiac disease and vice‐versa

Nikniaz

Beheshti

Farhangi

et al. 2021

Intl J Eating Disorders

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Objectives In the present systematic review and meta‐analysis study, we aimed to review studies that assessed the prevalence and risk of eating disorders (EDs) in patients with celiac disease (CD) and vice‐versa. Method We conducted a systematic search in PubMed, Embase, Scopus, and Web of Science for studies that assessed the prevalence and risk of AN in patients with CD and vice‐versa. Joanna Briggs Institute tools were used for critical appraisal. The STATA software was used for the meta‐analysis of the random‐effect model. Results In this study, 23 observational studies were included. The results of the meta‐analysis indicated that the pooled prevalence of EDs and bulimia nervosa in patients with CD was 8.88% [95% CI: 6.4, 11.7] and 7.26% [95% CI: 0.23, 21.57], respectively. Moreover, the risk of anorexia nervosa in patients with CD was significantly higher than in the healthy population (relative risk [RR]: 1.48 [95% CI: 1.32, 1.64]). The rates of CD in patients with AN and EDs were 0.96% [95% CI: 0.15, 2.31] and 0.90% [95% CI: 0.56, 1.31], respectively. Moreover, the overall risk of CD in patients with AN was significantly higher compared with healthy adults (RR: 2.35 [95% CI: 1.27–3.44]). Discussion The result of the present meta‐analysis showed the high prevalence of EDs in patients with CD. Moreover, there was a significant bidirectional association between CD and EDs.

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Shared Genetic Factors Involved in Celiac Disease, Type 2 Diabetes and Anorexia Nervosa Suggest Common Molecular Pathways for Chronic Diseases

Cited by 15 publications

References 48 publications

The intersect of gastrointestinal symptoms and malnutrition associated with anorexia nervosa and avoidant/restrictive food intake disorder: Functional or pathophysiologic?—A systematic review

The intersect of gastrointestinal symptoms and malnutrition associated with anorexia nervosa and avoidant/restrictive food intake disorder: Functional or pathophysiologic?—A systematic review

Clinical Picture of Celiac disease: Experience from a health care provider in Arabia

A systematic review and meta‐analysis of the prevalence and odds of eating disorders in patients with celiac disease and vice‐versa

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