Gluten sensitivity linked to increased death risk

A Swedish study has found patients with mild intestinal inflammation and gluten sensitivity have a higher risk of death, even if their symptoms are not severe enough to warrant a diagnosis of coeliac disease.

Similar findings from a study by the Mayo Clinic in the US in relation to undiagnosed coeliac disease were reported in the Allergen Bureau News .

The Swedish study looked at histopathology data from tissue biopsies collected from 46,121 patients nationwide between July 1969 and February 2008. Of those patients, 29,096 had coeliac disease, while 13,306 had inflammation of the small intestine and 3,719 had latent coeliac disease, in which patients tested positive for blood antibodies used as markers for coeliac disease but had no signs of intestinal inflammation or damage.

In all cases, the absolute mortality risk associated with coeliac disease and the milder intestinal problems was modest, with an excess mortality of 2.9 deaths per 1,000 person-years in coeliac disease and 10.8 and 1.7 deaths per 1,000 person-years in inflammation and latent coeliac disease, respectively. The main causes of death for these patients were cardiovascular disease and cancer.

The researchers suggested the increase in mortality might result from chronic inflammation that damages patients' small intestines or from malnutrition that reduces the availability of essential vitamins and energy. However, the researchers did not adjust for smoking, weight, and height, and data on patient's symptoms were not available. They also did not rule out the possibility that pre-existing diseases might have caused the increase in mortality.

Reference: Ludvigsson J, et al. 2009. Journal of the American Medical Association. Vol 302 pp. 1171-1178.