Celiac disease may increase risk for premature death by more than 20 percent, according to a Swedish study published Tuesday in JAMA.
Researchers found that the immune condition, in which sufferers experience damage to the small intestine from foods containing gluten, can cause early death from heart disease, cancer, and respiratory illnesses.
"We have known that celiac disease can cause a number of long-term complications that can impact life expectancy, but this study examines an entire population in the most recent era, at a time when awareness of celiac disease and access to gluten-free food is widespread," study co-author Benjamin Lebwohl, director of clinical research at the Celiac Disease Center at Columbia University, said in a statement. "Despite this, we found that celiac disease is associated with long-term consequences."
Celiac disease affects an estimated 1 percent of the population in the United States, or roughly 3 million people -- the vast majority of whom are undiagnosed.
The condition is an inherited autoimmune disorder that affects the digestive process in the small intestine after consumption of gluten, a protein found in wheat, rye, and barley.
In a person with celiac disease, the immune system to gluten responds by attacking the small intestine and inhibiting the absorption of important nutrients into the body.
Earlier research has demonstrated a modest but persistent increased risk of early death in people with celiac disease. However, in recent years, more people with milder disease have been diagnosed and gluten-free food is widely available.
Using nationwide data from Sweden's pathology departments, linked to national healthcare registers, Lebwohl and his colleagues examined data on nearly 50,000 people with the disease.
They found that, compared with healthy controls, overall mortality was 21 percent higher in people with celiac disease and that the relative increase in mortality risk was present in all age groups -- and greatest in those diagnosed in the age range of 18 to 39 years old.
Compared with controls, the overall mortality risk was greatest in the first year after diagnosis but the risk increase persisted for about 10 years after diagnosis.
"The intestinal inflammation is often most intense around diagnosis, and before a gluten-free diet has had an effect on mucosal healing," said co-author Jonas F. Ludvigsson, senior pediatrician at Örebro University Hospital and professor of clinical epidemiology at the Karolinska Institutet in Sweden. "Celiac disease is characterized by inflammation, which is generally bad for your health. I am therefore not surprised that we found increased mortality for a number of causes of death in individuals with celiac disease."