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Risk of diabetes and cardiovascular disease in patients with primary sclerosing cholangitis

Ludvigsson, J.F. and Bergquist, A. and Montgomery, S.M. and Bahmanyar, S. (2014) Risk of diabetes and cardiovascular disease in patients with primary sclerosing cholangitis. Journal of Hepatology, 60 (4). pp. 802-808. ISSN 01688278 (ISSN)

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Abstract

Background & Aims Primary sclerosing cholangitis (PSC) is associated with increased mortality. Cardiovascular disease is a leading cause of death in the Western world. We examined the risk of cardiovascular disease and diabetes (type 1 and type 2) in patients with PSC and their first-degree relatives. Methods This prospective multicentre cohort study included 678 individuals with PSC diagnosed between 1970 and 2004, and 6347 non-PSC reference individuals matched for age, and sex. Through linkage of the Swedish Multigeneration Register we identified 3139 first-degree relatives to PSC patients and 30,953 first-degree relatives to the matched comparison cohort. We retrieved data on cardiovascular disease and type 1 and type 2 diabetes (T1D and T2D) from the National Patient Register, and then examined the association with PSC or having a family history of PSC using Poisson regression. Results During 125,127 person-years of follow-up, 203 individuals with PSC had a diagnosis of cardiovascular disease. This corresponded to a 3.34-fold increased relative risk (RR) of cardiovascular disease in individuals with PSC (95% CI = 2.86-3.91). The highest risk estimates were seen for diseases of the arteries, veins, and lymphatic vessels while the RR was neutral for ischemic heart disease (0.90) or only slightly elevated for cerebrovascular disease (1.74). Meanwhile, PSC first-degree relatives were at no increased risk of cardiovascular disease (RR = 0.87; 95% CI = 0.80-0.95). Individuals with PSC (RR = 7.95; 95% CI = 4.82-13.12), and to some extent also their first-degree relatives (RR = 1.73; 95% CI = 1.19-2.52) were at increased risk of T1D. Also for T2D were the RR is higher in individuals with PSC (RR = 2.54; 95% CI = 1.56-4.13) than in PSC first-degree relatives (RR = 0.81; 95% CI = 0.65-1.02). Conclusions PSC was associated with T1D, T2D, and non-ischemic cardiovascular disease. In contrast, first-degree relatives to PSC patients were only at a moderately increased risk of T1D, and at no increased risk of either cardiovascular disease or T2D. © 2013 European Association for the Study of the Liver. Published.

Item Type: Article
Additional Information: Unmapped bibliographic data: LA - English [Field not mapped to EPrints] J2 - J. Hepatol. [Field not mapped to EPrints] AD - Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Sweden [Field not mapped to EPrints] AD - Department of Pediatrics, �rebro University Hospital, Sweden [Field not mapped to EPrints] AD - Department of Gastroenterology and Hepatology, Karolinska University Hospital, Karolinska Institutet, Sweden [Field not mapped to EPrints] AD - Clinical Epidemiology and Biostatistics, �rebro University Hospital, �rebro University, �rebro, Sweden [Field not mapped to EPrints] AD - Department of Epidemiology and Public Health, University College London, United Kingdom [Field not mapped to EPrints] AD - Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran [Field not mapped to EPrints] DB - Scopus [Field not mapped to EPrints]
Uncontrolled Keywords: Bile duct diseases, Diabetes, Heart, Liver, Primary sclerosing cholangitis, adult, artery disease, article, cardiovascular disease, cardiovascular risk, cerebrovascular disease, cohort analysis, controlled study, cor pulmonale, disease association, family history, female, first degree relative, follow up, human, insulin dependent diabetes mellitus, ischemic heart disease, lymph vessel, major clinical study, male, middle aged, non insulin dependent diabetes mellitus, primary sclerosing cholangitis, priority journal, prospective study, register, risk assessment, risk factor, Sweden, vein disease
Subjects: مقالات نمایه شده محققین دانشگاه در سایت ,Web of Science ,Scopus
موارد کلی
Divisions: معاونت تحقیقات و فناوری
Depositing User: GOUMS
Date Deposited: 19 Apr 2015 04:03
Last Modified: 05 May 2015 04:47
URI: http://eprints.goums.ac.ir/id/eprint/1717

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