The risk for developing celiac disease was increased in children who had a gastrointestinal or respiratory infection during their first year of life, especially among those with multiple GI infections, according to the results of a German study.
“Our data do not allow a conclusion whether the observed associations are causal or are based on changes in the microbiome or specific immune responses,” Andreas Beyerlein, PhD, of the Institute of Diabetes Research at Helmholtz Zentrum München, a partner in the German Center for Diabetes Research, said in a press release. “However, it seems that the increased risk of celiac disease is associated with a permanent inflammation of the gastrointestinal tract in early childhood and is not caused by a specific viral or bacterial pathogen.”
Beyerlein and colleagues previously observed an association between the risk for type 1 diabetes and early life infections, particularly among children with multiple respiratory infections in the first 6 months of their lives.
In the current study, the researchers evaluated for associations between infections up to age 2 years and later development of celiac disease using prospective claims data on 295,420 infants born between 2005 and 2007 in Bavaria — representing more than 90% of all children born in the area during this period — and followed for a median of 8.5 years.
After adjusting for sex, birth month and prior health care visits, the investigators found that children who had a GI infection (HR = 1.32; 95% CI, 1.12-1.55) or a respiratory infection (HR = 1.22; 95% CI, 1.04-1.43) during the first year of their lives had a higher risk for developing celiac disease.
These hazard ratios corresponded to incidence rates of 46 vs. 34 celiac diagnoses per 100,000 person years in children with and without GI infections, respectively, and 38 vs. 32 celiac diagnoses per 100,000 person years in children with and without respiratory infections.
“Repeated respiratory and particularly gastrointestinal infections during the first year of life were associated with increased cumulative risk of [celiac disease] in later life,” Beyerlein and colleagues wrote. They concluded that early GI infections may be more relevant for development of celiac disease rather than type 1 diabetes, “for which early respiratory infection have been found to be more relevant in the same data.” – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.