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Bidirectional relationship between eating disorders and autoimmune diseases.

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posted on 2024-10-29, 08:03 authored by Anna HedmanAnna Hedman, Lauren Breithaupt, Christopher Hübel, Laura M Thornton, Annika Tillander, Claes Norring, Andreas BirgegårdAndreas Birgegård, Henrik LarssonHenrik Larsson, Jonas LudvigssonJonas Ludvigsson, Lars SävendahlLars Sävendahl, Catarina Almqvist MalmrosCatarina Almqvist Malmros, Cynthia BulikCynthia Bulik
BACKGROUND: Immune system dysfunction may be associated with eating disorders (ED) and could have implications for detection, risk assessment, and treatment of both autoimmune diseases and EDs. However, questions regarding the nature of the relationship between these two disease entities remain. We evaluated the strength of associations for the bidirectional relationships between EDs and autoimmune diseases. METHODS: In this nationwide population-based study, Swedish registers were linked to establish a cohort of more than 2.5 million individuals born in Sweden between January 1, 1979 and December 31, 2005 and followed up until December 2013. Cox proportional hazard regression models were used to investigate: (a) subsequent risk of EDs in individuals with autoimmune diseases; and (b) subsequent risk of autoimmune diseases in individuals with EDs. RESULTS: We observed a strong, bidirectional relationship between the two illness classes indicating that diagnosis in one illness class increased the risk of the other. In women, the diagnoses of autoimmune disease increased subsequent hazards of anorexia nervosa (AN), bulimia nervosa (BN), and other eating disorders (OED). Similarly, AN, BN, and OED increased subsequent hazards of autoimmune diseases.Gastrointestinal-related autoimmune diseases such as, celiac disease and Crohn's disease showed a bidirectional relationship with AN and OED. Psoriasis showed a bidirectional relationship with OED. The previous occurence of type 1 diabetes increased the risk for AN, BN, and OED. In men, we did not observe a bidirectional pattern, but prior autoimmune arthritis increased the risk for OED. CONCLUSIONS: The interactions between EDs and autoimmune diseases support the previously reported associations. The bidirectional risk pattern observed in women suggests either a shared mechanism or a third mediating variable contributing to the association of these illnesses.

Funding

Establishing the World Center for Innovation in Eating Disorders Research : Swedish Research Council | 2013-08864_VR

Unique registers and advanced family designs to address causes and consequences of common childhood disorders : Swedish Research Council | 2013-05867_VR

History

File version

  • Accepted manuscript

Publication status

Published

Sub type

Article

Journal

J Child Psychol Psychiatry

ISSN

0021-9630

eISSN

1469-7610

Volume

60

Issue

7

Language

  • eng

Original self archiving date

2018-11-26

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