Atherosclerosis in Diabetes: Celiac Disease as a Cherry on the Cake

Abstract

IntroductionFew study has been conducted to unmask the potential role of celiac disease (CD) as a supplementary cardio-vascular risk factor in diabetes mellitus (DM) patients developing atherosclerosis. We conducted a systematic review to explore this peculiar association and discussed the related investigational studies. Material and MethodsWe carried out a systematic search on PubMed* via the query: (((“Atherosclerosis”[Mesh]) AND “Celiac Disease”[Mesh]) AND “Diabetes Mellitus”[Mesh]) AND (atherosclerosis[Title/Abstract] AND (celiac disease[Title/Abstract] OR coeliac disease[Title/Abstract]) AND (diabetes[Title/Abstract])) ResultsWe retrieved only 4 investigational studies: - carotid intima-media thickness (c-IMT) was significantly greater in patients with DM+CD than in patients with DM or CD (P<0.001) (Atherosclerosis, 2011) - Patients with DM+CD had lower HDL levels than patients with DM only (P = 0.017), i.e had a more atherogenic lipid profile (J Pediatr Endocrinol Metab, 2014) - In a Polish study, coexistence of CD with DM was not associated with a greater value of cIMT (Pediatr Endocrinol Diabetes Metab, 2016) - Mean value of atherosclerosis index in DM + CD was higher than in DM (P < 0.05) (Clin Biochem, 2018) ConclusionCeliac disease is a potential risk factor for developing athersclerosis in diabetic patients More studies with large series are needed to clarify this link and guide screening and management in clinical practice.