Increased risk of cardiovascular disease in celiac disease
People with celiac disease and dermatitis herpetiformis have a slightly increased risk of cardiovascular disease, certain types of blood cancer, and premature death. This is shown by a large U.S. registry study led by researchers at Karolinska Institutet. The results are published in the journal The Lancet Regional Health – Americas.
Celiac disease is an autoimmune condition in which the body’s immune system reacts to gluten. Dermatitis herpetiformis, also known as cutaneous celiac disease, is a skin manifestation of the same condition and causes itchy blisters and rashes. Previous research on long-term health risks in these conditions has yielded conflicting results, particularly outside Europe.
In the new study, the researchers analysed medical record data from the United States between 2005 and 2025. In total, just over 200,000 adults with celiac disease and nearly 7,000 with dermatitis herpetiformis were included. Each individual was matched with a control person without the condition with similar age, sex, smoking habits, and other medical conditions.
Small increases in risk that may become significant at the population level
The results show that individuals with celiac disease had an 18 percent higher risk of death during the follow-up period compared with the control group. They also had a slightly increased risk of major cardiovascular events such as heart attack, stroke, and heart failure. Individuals with dermatitis herpetiformis also had an increased risk of cardiovascular disease and mortality, but the results were more uncertain in some analyses.
“The risk increases are relatively small for the individual, but since celiac disease is a common condition, the effects can still be significant at the population level,” says Philip Curman, physician and associate professor at the Department of Medical Epidemiology and Biostatistics and the Department of Medicine, Karolinska Institutet.
“It is interesting that celiac disease is also linked to cardiovascular disease. In that area, previous studies have been conflicting,” says Jonas F. Ludvigsson, professor, pediatrician, and one of the study’s co-authors.
Important to follow patients with celiac disease and dermatitis herpetiformis
The study also found differences in cancer risk. People with celiac disease had an increased risk of blood cancers, particularly non-Hodgkin lymphoma, but no increased risk of solid tumors. For dermatitis herpetiformis, a clearly increased risk of non-Hodgkin lymphoma was observed, while the risk of other cancer types was not elevated.
“Our results suggest that both cardiovascular health and certain types of cancer may be important to monitor when following up patients with celiac disease and dermatitis herpetiformis,” says Philip Curman.
The researchers emphasize that the study is based on medical record data and lacks information on factors such as dietary treatment and adherence to a gluten-free diet, which is an important limitation.
The study was conducted in collaboration with researchers in Sweden, the United States, Canada, and Germany. The research was funded by, among others, Region Stockholm and Karolinska Institutet.
Publication
Mortality, cardiovascular disease, and cancer in coeliac disease and dermatitis herpetiformis: a matched cohort study. Jonas F. Ludvigsson, Jason Dagher, Benjamin Lebwohl, Jialu Yao, Peter H.R. Green, Ralf J. Ludwig, Philip Curman. The Lancet Regional Health – Americas. Online 28 May 2026, doi: 10.1016/j.lana.2026.101512.