C0639 - Incidence and Risk of Diseases of the Musculoskeletal Systems and Connective Tissues in Celiac Disease Patients

Maryam Haider, MD¹, Raseen Tariq, MD², Rawan Aljaras, MD³, Jasleen Kaur, MD⁴, Paul Naylor, PhD^5
1Wayne State University/Detroit Medical Center Sinai Grace Hospital, Detroit, MI; ²Mayo Clinic, Rochester, MN; ³Indiana University School of Medicine, Indianapolis, IN; ⁴Ascension Medical Group, Saginaw, MI; ⁵Wayne State University School of Medicine, Detroit, MI

Introduction: Celiac disease (CD) is an autoimmune-based reaction to dietary gluten found predominantly in wheat, barley, or rye. The main pathogenesis occurs in the intestinal mucosa by lymphocytic infiltration with subsequent destruction of the intestinal villi architecture. We aimed to identify the prevalence level of diseases of the musculoskeletal system and connective tissues in hospitalized CD patients.

Methods: NIS database was queried from September 2015 to December 2019 to retrieve records of patients admitted with a principal or secondary diagnosis of CD. We compared the incidence of diseases of the musculoskeletal system and connective tissues in CD (cases) to patients who did not have CD (controls). Controls were 1:1 fixed ratio nearest neighbor (greedy) propensity score-matched using the patient’s age, sex, and race. We used clinical classification software refined (CCSR) for ICD-10-CM diagnosis v2021 and identified diseases of the musculoskeletal system and connective tissues. We used the Rao-Scott chi-square test on the weighted sample. We used alpha = 0.01 and P value < 0.001 considered statistically significant. Statistical analysis is performed in R (Studio 1.4).

Results: A total of 178,590 records (no outpatient) identified with CD in the weighted sample. Compared to non-CD matched patients, CD patients have an increased prevalence of juvenile arthritis (OR, 5.15 99% CI, 2.42 – 10.99; p < 0.001), systemic lupus erythematosus (OR, 3.27; 99% CI, 2.84 – 3.78; p < 0.001), osteoporosis (OR, 2.97; 99% CI, 2.68 – 3.29; p < 0.001), scoliosis (OR, 1.79; 99% CI, 1.48 – 2.17; p < 0.001), rheumatoid arthritis (OR, 1.78; 99% CI, 1.58 – 2.03; p < 0.001), stress fracture (OR, 1.68; 99% CI, 1.19 – 2.36; p < 0.001), spondylopathies/spondyloarthropathy (OR, 1.46; 99% CI, 1.33 – 1.61; p < 0.001, gout (OR, 1.44; 99% CI, 1.26 – 1.64; p < 0.001), and low back pain (OR, 1.21; 99% CI, 1.08 – 1.35; p < 0.001). CD patients are at low risk of osteomyelitis (OR, 0.74; 95% CI, 0.60 – 0.94; p < 0.001) and muscle disorders (OR, 0.83; 95% CI, 0.70 – 0.97; p < 0.01).

Discussion: CD is a multisystem autoimmune condition with clinical presentations including musculoskeletal and rheumatological complaints. CD appears to have an increased risk of having another autoimmune disorder, little is known about the risk factors, pathogenesis, and relationship between CD and rheumatological conditions like SLE, Spondyloarthropathies, and Gout. We propose screening for CD in some patients and a need for rheumatologic follow-up.



Disclosures:


Maryam Haider, MD¹, Raseen Tariq, MD², Rawan Aljaras, MD³, Jasleen Kaur, MD⁴, Paul Naylor, PhD⁵. C0639 - Incidence and Risk of Diseases of the Musculoskeletal Systems and Connective Tissues in Celiac Disease Patients, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.