Anorexia Nervosa Linked to Celiac Disease in Women
Underdiagnosis and misdiagnosis of anorexia nervosa and celiac disease could cause protracted and unnecessary morbidity
HealthDay News — There is a bidirectional association between anorexia nervosa (AN) diagnosis and celiac disease (CD) in women, according to a study published online in Pediatrics.
Karl Mårild, MD, PhD, from the Norwegian Institute of Public Health in Oslo, and colleagues examined whether CD is associated with AN in a register-based cohort and case-control study. Data were included for 17,959 women with CD (diagnosed at a median age of 28 years) and 89,379 sex- and age-matched population-based controls.
The researchers found that 54 patients with CD were diagnosed with AN during 1,174,401 person-years of follow-up (27/100,000 person-years) compared with 180 matched controls (18/100,000 person-years). The hazard ratios for later AN and for AN beyond the first year after CD diagnosis were 1.46 (95 percent confidence interval, 1.08 to 1.98) and 1.31 (95 percent confidence interval, 0.95 to 1.81), respectively. There was also a correlation for previous AN diagnosis with CD (odds ratio, 2.18; 95 percent confidence interval, 1.45 to 3.29). After adjustment for socioeconomic characteristics and type 1 diabetes the estimates were largely unchanged.
"The bidirectional association between AN diagnosis and CD warrants attention in the initial assessment and follow-up of these conditions because underdiagnosis and misdiagnosis of these disorders likely cause protracted and unnecessary morbidity," the authors write.
One author disclosed financial ties to Shire.
Mårild K, Størdal K, Bulik CM, et al. Celiac Disease and Anorexia Nervosa: A Nationwide Study. Pediatrics. 2017; doi/10.1542/peds.2017-0545.