West Virginia University School of Medicine Morgantown, WV
Introduction: Celiac disease (CD) is an immune-mediated enteropathy associated with inflammation precipitated by dietary gluten in genetically predisposed individuals. Few studies reported a higher incidence of pancreatitis in the CD population. It is unclear whether this risk has changed in the era of more comprehensive diagnosis rates and less severe clinical disease. Using a large database, we sought to evaluate the association between CD and acute pancreatitis (AP), chronic pancreatitis (CP), and pancreatic cancer(PC) risk at a population level.
Methods: This multicenter, retrospective cohort study was conducted using the TriNetX platform. All adult patients ( >18 years) diagnosed with CD were identified based on ICD-10 codes between March 2005 and April 2022. The primary outcome was the occurrence of AP and CP in CD patients. Secondary outcomes were the incidence of PC and mortality. Any patients with a history of pancreatic disease events before March 2005 were excluded. Data were matched with individuals without CD during the same period. We performed a 1:1 propensity score matching (PSM) for demographics, smoking, alcohol-related disease, diabetes, hyperlipidemia, and comorbid conditions. The risk ratio (RR) was calculated to compare the association between CD and the outcome
Results: A total of 479,020 patients were analyzed, and there were 162,362 patients with CD. After PSM, there were 142,902 patients with CD or without CD. The mean age of patients was 41.7 years, with 70.7% women and 78% White. Patients in the CD group had a higher prevalence of comorbidities such as diabetes and hypercholesterolemia than those without CD. The incidence of AP and CP after 3 years of CD diagnosis was 0.19% and 0.39%, respectively; PC and mortality were 0.04% and 1.16% compared to non-CD patients. Individuals with CD had a higher risk of AP (RR 1.30; 95% CI 1.08-1.56), CP(1.57; 95% CI 1.37-1.80), PC(1.48; 1.01-2.16) and mortality (RR 1.36; 95% CI 1.26-1.46) than non-CD patients (Table 1)
Discussion: This population-based multicenter study suggests that individuals with CD are at increased risk of pancreatitis, PC, and mortality
