Published: 01-10-2018 08:53 | Updated: 02-10-2018 08:23

Cinnamon Bun Day and celiac disease

On Thursday (Oct 4), Swedes celebrate Cinnamon Bun Day (”Kanelbullens dag”). This is also a day when society and healthcare pay attention to celiac disease An estimated 1% of the population in Western countries (translating into 100,000 individuals in Sweden) have celiac disease. Many go undiagnosed. Celiac diseases is characterised by small intestinal inflammation triggered by gluten, occurring in wheat, rye and barley. Patients may suffer from e.g. poor growth/weight loss, diarrhea, abdominal pain, depression, osteoporosis and anemia.

In a 5-year-project, researchers from Karolinska Institutet and Columbia University, New York, US, have examined the prevalence of celiac disease in risk groups of patients. This project was recently concluded when the researchers published a paper in Gastroenterology showing that 1 in 31 individuals with iron-deficiency anaemia suffer from celiac disease.

-All four studies within our project are so-called meta-analyses. This means that we have performed systematic literature reviews and then selected studies that fulfil predefined criteria to ensure a high quality of the research. The prevalence of celiac disease in each single study was then pooled into one risk estimate and weighted to reflect the size of individual studies, says lead investigator Professor Jonas F Ludvigsson at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.

-In our study on iron-deficiency anemia we identified 18 studies with a total of 2998 patients screened for celiac disease. Some 3.2% (translating into 1 in every 31 patients) with iron deficiency had celiac disease.

Similarly the same research group have demonstrated that 1.6% of patients with osteoporosis had celiac disease (1 in 62 patients) (Alimentary Pharmacology and Therapeutics, 2018). The same prevalence (1.6% of patients) with autoimmune thyroid sieges also had celiac disease (Thyroid, 2016).

The highest prevalence of celiac disease was seen in type 1 diabetes: 6.0% (Alimentary Pharmacology and Therapeutics, 2014). Ludvigsson et al managed to identify 27 studies with a total of more than 26000 patients with typ1 1 diabetes who had undergone screening for celiac disease. One in every 17 patients with type 1 diabetes also had celiac disease.

-These collaborations with Columbia university show how important it is to screen risk groups for celiac disease, especially patients with type 1 diabetes and iron-deficiency anaemia, says Ludvigsson. Celiac patients who start on a gluten-free diet almost always improve their symptoms and some associated conditions such as iron-deficiency anaemia and osteoporosis are likely to improve.

Additional information: Jonas F Ludvigsson has an adjunct professorship at Columbia University, New York, US.

Contact information:


Jonas Ludvigsson

Phone: +46-(0)8-524 823 56
Organizational unit: C8.MEB.Ludvigsson

Link to publications in PubMED

Prevalence of Celiac Disease in Patients With Iron Deficiency Anemia-A Systematic Review With Meta-analysis.
Mahadev S, Laszkowska M, Sundström J, Björkholm M, Lebwohl B, Green P, et al
Gastroenterology 2018 08;155(2):374-382.e1

Systematic review with meta-analysis: the prevalence of coeliac disease in patients with osteoporosis.
Laszkowska M, Mahadev S, Sundström J, Lebwohl B, Green P, Michaelsson K, et al
Aliment. Pharmacol. Ther. 2018 Sep;48(6):590-597

Prevalence of Celiac Disease in Patients with Autoimmune Thyroid Disease: A Meta-Analysis.
Roy A, Laszkowska M, Sundström J, Lebwohl B, Green P, Kämpe O, et al
Thyroid 2016 07;26(7):880-90

Systematic review with meta-analysis: associations between coeliac disease and type 1 diabetes.
Elfström P, Sundström J, Ludvigsson J
Aliment. Pharmacol. Ther. 2014 Nov;40(10):1123-32