Acid Suppression and Antibiotics Administered during Infancy Are Associated with Celiac Disease - 14/03/23
, Apryl Susi, MS 1, Elizabeth Hisle-Gorman, MSW, PhD 2, Philip L. Rogers, MD 1, Cade M. Nylund, MD 1, 2Abstract |
Objective |
To investigate why certain at-risk individuals develop celiac disease (CD), we examined the association of proton pump inhibitors (PPI), histamine-2 receptor antagonists (H2RAs), and antibiotic prescriptions in the first 6 months of life with an early childhood diagnosis of CD.
Study design |
A retrospective cohort study was performed using the Military Healthcare System database. Children with a birth record from October 1, 2001, to September 30, 2013, were identified. Outpatient prescription records were queried for antibiotic, PPI, and H2RA prescriptions in the first 6 months of life. Cox proportional hazards regression was used to calculate the hazard ratio (HR) of developing CD based on medication exposure. International Classification of Diseases, Ninth Revision, Clinical Modification codes identified children with an outpatient visit for CD.
Results |
There were 968 524 children who met the inclusion criteria with 1704 cases of CD in this group. The median follow-up for the cohort was approximately 4.5 years. PPIs (HR, 2.23; 95% CI, 1.76-2.83), H2RAs (HR, 1.94; 95% CI, 1.67-2.26), and antibiotics (HR, 1.14; 95% CI, 1.02-1.28) were all associated with an increased hazard of CD.
Conclusions |
There is an increased risk of developing CD if antibiotics, PPIs and H2RAs are prescribed in the first 6 months of life. Our study highlights modifiable factors, such as medication stewardship, that may change the childhood risk of CD.
Le texte complet de cet article est disponible en PDF.Keywords : diet, celiac disease epidemiology, gluten, environmental exposure, risk factors, age of onset, zonulin
Abbreviations : CD, H2RA, HR, ICD-9-CM, MHS, PPI
Plan
| This work was prepared as part of the official duties of M.B. and C.N., who are employed by the United States Army and the United States Air Force. The views expressed in this article are those of the authors, and do not reflect the official policy or position Uniformed Services University of the Health Sciences, The United States Army, the United States Air Force, Department of Defense, or the U.S. Government. The authors declare no conflicts of interest. |
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| Portions of this study were presented as a poster during the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition conference, October 17-19, 2019, Chicago, IL. |
Vol 254
P. 61 - mars 2023 Retour au numéro
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