SNFGE SNFGE
 
Thématique :
- Colo-proctologie
Originalité :
Intermédiaire
Solidité :
Intermédiaire
Doit faire évoluer notre pratique :
Pas encore
 
 
Nom du veilleur :
Docteur Pauline JOUET
Coup de coeur :
 
 
Gastroenterology
  2019/06  
 
  2019 Jun;156(8):2217-2229.  
  doi: 10.1053/j.gastro.2019.02.039.  
 
  Association Between Antibiotics in the First Year of Life and Celiac Disease.  
 
  Dydensborg Sander S, Nybo Andersen AM, Murray JA, Karlstad Ø, Husby S, Størdal K  
  https://www.ncbi.nlm.nih.gov/pubmed/30836095  
 
 

Abstract

BACKGROUND & AIMS:

The intestinal microbiota is believed to be involved in the pathogenesis of celiac disease, in addition to genetic variants and dietary gluten. The gut microbiota is strongly influenced by systemic antibiotics-especially in early life. We explored the association between exposure to a systemic antibiotic in the first year of life and risk of diagnosed celiac disease.

METHODS:

We performed an observational nationwide register-based cohort study. We included all children born in Denmark from 1995 through 2012 or Norway from 2004 through 2012. Children born in Denmark were followed until May 8, 2015 (age at end of follow-up was 2.3-20.3 years) and children born in Norway were followed until December 31, 2013 (age at end of follow-up was 1-10 years). We collected medical information from more than 1.7 million children, including 3346 with a diagnosis of celiac disease. Exposure to systemic antibiotics was defined as a dispensed systemic antibiotic in the first year of life.

RESULTS:

Exposure to systemic antibiotics in the first year of life was positively associated with diagnosed celiac disease in the Danish and Norwegian cohorts (pooled odds ratio 1.26, 95% confidence interval 1.16-1.36). We found a dose-dependent relation between an increasing number of dispensed antibiotics and the risk of celiac disease (pooled odds ratio for each additional dispensed antibiotic 1.08, 95% confidence interval 1.05-1.11). No specific type of antibiotic or age period within the first year of life was prominent. Adjustment for hospital admissions with an infectious disease in the first year of life did not change the estimates; adjustment for the number of maternally reported infections in the child in 2 large sub-cohorts decreased the association slightly (pooled odds ratio 1.18, 95% confidence interval 0.98-1.39).

CONCLUSION:

In a nationwide study of children in Denmark and Norway, we found exposure to systemic antibiotics in the first year of life to be associated with a later diagnosis of celiac disease. These findings indicate that childhood exposure to systemic antibiotics could be a risk factor for celiac disease.

 

 
Question posée
 
L’exposition à des antibiotiques la première année de vie augmente-t-elle le risque de développer une maladie cœliaque ?
 
Question posée
 
Dans cette étude des pays nordiques (Norvège, Danemark) portant sur plus de 1,7 millions d’enfants dont 3346 ayant une maladie cœliaque, il existait une relation dose dépendante entre le nombre d’antibiotiques prescrits pendant la première année de vie et le risque de développer une maladie cœliaque plus tard dans l’enfance ( OR 1,26, IC 95% 1,16–1,36).
 
Commentaires

La prise d’antibiotiques dans la petite enfance n’est probablement pas le facteur principal de maladie cœliaque mais pourrait être un facteur favorisant le développement de cette pathologie d’après les résultats de cette étude au nombre très impressionnant de patients inclus.

 
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