Cigarette smoking and celiac sprue: A case-control study

OBJECTIVE: Environmental factors other than gliadin exposure and certain HL A haplotypes may play a role in the pathogenesis of celiac disease. Previou s studies have suggested a strong inverse relationship between cigarette sm oking and celiac disease. We sought to determine the relationship between c eliac disease and cigarette smoking in our patient population. METHODS: All newly diagnosed adults with biopsy-proven celiac disease evalu ated at Mayo Clinic Rochester between January 1, 1993, and June 30, 1998, w ere identified. Three clinic patients who were matched to each case on geog raphical area of residence, age. gender. and calendar year of visit served as controls. Smoking information was obtained from a standard medical quest ionnaire that was completed by all clinic patients at the time of registrat ion. The adjusted odds ratio for celiac disease in current and former smoke rs relative to nonsmokers was estimated with a matched three-to-one conditi onal logistic regression model. RESULTS: A total of 82 adults with biopsy-proven celiac disease were identi fied. At the time of diagnosis, the proportion of current smokers was 10% i n cases and 10% in controls, yielding an adjusted odds ratio of 1.5 (95% CI = 0.5-4.3). In all, 34% of cases were former smokers versus 28% of control s, yielding an odds ratio of 1.6 (95% CI 0.8-3.2). CONCLUSION: This case-control study was unable to detect an association bet ween cigarette smoking and celiac disease. (C) 2001 by Am. Coll. of Gastroe nterology.