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Association between coeliac disease and cardiovascular disease: prospective analysis of UK Biobank data
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    Associatoin between coeliac nad cardiovascular diseases ?
    • MJ Quinn, Visiting Fellow Shanghai JiaoTong University

    Dr Conroy and colleagues investigated 469,095 adults aged 40-69, to find 40687 incident events (9 per 1000 person years) of cardiovascular disease in 2083 coeliac sufferers giving a hazard ration of 1.27 (1.11- 1.45) (1). What are the mechanisms for these clinical associations ?

    The pathophysiological mechanism in DP Burkitt”s “high fibre” hypothesis to explain chronic diseases is autonomic injury caused by straining on the toilet (2, 3). Coordinated straining may injure branches of sympathetic segments T10-L2 with the potential to injure pelvic organs including kidneys and adrenals. These may extend to contiguous segments at T8-9r supplying small bowel (cf nulliparous endometriosis, inflammatory bowel disease and hypertension). In DP Barkers “fetal origins of adult diseases” hypothesis the pathophysiological mechanism is an in utero injury to autonomic vasomotor nerves in small babies caused by involuntary “fetal hypertension” (4, 5). Kidneys and pancreas seem to bear the brunt of this assault that may result in type 1 diabetes mellitus and hypertension in later life.

    On this simple analysis there are, therefore, potential primary neurological mechanisms to account for both cardiovascular and autoimmune diseases within these data-driven hypotheses for chronic diseases. Are autoantibodies secondary consequences of primary denervatory injuries in these chronic “autoimmune” conditions ?. If the BioBank held details of birthweights or bowel habits (...

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    Conflict of Interest:
    None declared.