Suman, S.; Williams, E.J.; Thomas, P.W.; Surgenor, S.L.; Snook, J.A.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA9
Academic Journal
Introduction and Aim: Previous studies have shown an association between cigarette smoking and the risk oF development of adult coeliac disease (CD), but it has yet to be established whether this relationship is causal. The aim of this study was to assess causality using the Bradford-Hill criteria, specifically seeking evidence of a biological gradient. Method: Matched case control study using a questionnaire to establish a detailed smoking history for 138 incident cases of adult CD and 276 age and sex matched controls. Subjects were categorised according to various measures of the duration and intensity of active cigarette exposure prior to diagnosis of the matched case. Conditional logistic regression was used to calculate odds ratios and linear trends. Result: At the time of diagnosis, 10% of cases and 30% of controls were current smokers (odds ratio 0.21, 95% CI 0.11-0.40 for CD in current v never-smokers). The odds of developing CD fell significantly with both increasing total lifetime exposure and exposure to cigarettes over the 15 years prior to diagnosis. However, the strongest relationship was with the number of cigarettes smoked per day at the time of diagnosis (odds ratio 0.15, CI 0.06-0.37, for CD in current heavy v never-smokers). All linear trends were highly statistically significant and controlling the data for standard of living did not alter the findings. Conclusion: This study strengthens the case for a causal relationship between smoking and CD by demonstrating a strong, temporally appropriate and dose dependent effect, thus meeting the Bradford-Hill criteria. This suggests that cigarette smoking truly protects against the development of adult CD.


Related Articles

  • Coeliac disease 'does not add to fracture risk'. Dragon, Natalie // GP: General Practitioner;4/7/2003, p10 

    Patients with coeliac disease should not be routinely screened for osteoporosis as current guidelines suggest, according to UK researchers. They found patients with coeliac disease were at no greater risk of developing fractures than the general population.A total of 244 patients diagnosed with...

  • Relation Between Cigarette Smoking and Celiac Disease: Evidence From a Case-Control Study. Vazquez, Horacio; Smecuol, Edgardo; Flores, Daniel; Mazure, Roberto; Pedreira, Silvia; Niveloni, Sonia; Mauriño, Eduardo; Bai, Julio C. // American Journal of Gastroenterology;Mar2001, Vol. 96 Issue 3, p798 

    OBJECTIVES: It has been suggested that environmental factors other than gliadin might play a role in pathogenesis of celiac disease. Cigarette smoking was reported to exert a protective effect against the development of symptomatic celiac disease; however, this relationship was not confirmed....

  • Cigarette Smoking and Celiac Sprue: A Case-Control Study. Patel, Anand H.; Loftus Jr., Edward V.; Murray, Joseph A.; Harmsen, W. Scott; Zinsmeister, Alan R.; Sandborn, William J. // American Journal of Gastroenterology;Aug2001, Vol. 96 Issue 8, p2388 

    OBJECTIVE: Environmental factors other than gliadin exposure and certain HLA haplotypes may play a role in the pathogenesis of celiac disease. Previous studies have suggested a strong inverse relationship between cigarette smoking and celiac disease. We sought to determine the relationship...

  • Environmental Medicine Update. Marchese, Marianne // Townsend Letter;Nov2012, Issue 352, p107 

    The article discusses the origin of multiple sclerosis affecting more women between 20 and 40 years old with no definite cure. The report presents genetic and environmental influences in the etiology of the neurological disorder. An overview of these influences is presented including genetic...

  • Coping with celiac disease.  // Tufts University Health & Nutrition Letter;Sep98, Vol. 16 Issue 7, p1 

    Presents information on the intestinal disorder called celiac disease. Background information on the disease; Symptoms of the disease; How the disease can be treated.

  • Detecting Celiac disease in your patients. Pruessner, Harold T. // American Family Physician;3/1/1998, Vol. 57 Issue 5, p1023 

    Presents information in relation to Celiac disease. Definition of Celiac disease; Indepth look at the prevalence of the disease; Reference to a study promoted by the European Society of Paediatric Gastroenterology and Nutrition; Details on the relation between the disease and diabetes mellitus.

  • Celiac disease.  // American Family Physician;3/1/1998, Vol. 57 Issue 5, p1039 

    Presents information on Celiac disease. Definition of Celiac disease; Insight on how to control the disease; How can an individual get the disease; Details on the effects of the disease.

  • Clinical features of coeliac disease in the elderly.  // Age & Ageing;Jan97 Supplement, Vol. 26, p44 

    Presents an abstract of the study `Clinical Features of Coeliac Disease in the Elderly,' by D.M. Beaumont and M. Mian, presented during the communications to the autumn meeting of the British Geriatrics Society on October 3-4, 1996 in London, England.

  • Celiac Disease.  // Today's Diet & Nutrition;May2011, Vol. 7 Issue 5, p2 

    An introduction is presented in which the editor discusses the emergence of celiac disease in the U.S.


Read the Article


Sign out of this library

Other Topics