Risk of venous thromboembolism in patients with celiac disease: A systematic review and meta-analysis

Abstract

Background and aim: Patients with celiac disease (CD) might be at an increased risk of developing venous thromboembolism (VTE) due to chronic inflammation and vitamin deficiency. However, epidemiologic studies attempting to investigate this risk have yielded inconsistent results. We conducted this meta-analysis with the aims to better characterize this possible association.

Methods: We conducted a systematic review and meta-analysis of observational studies that reported odds ratio, relative risk, hazard ratio, or standardized incidence ratio comparing the risk of VTE in patients with CD versus participants without CD. Generic inverse variance method of DerSimonian and Laird was used to calculate the pooled risk ratio.

Results: Out of 279 potentially relevant articles, four studies met the inclusion criteria and were included in the meta-analysis. We found a statistically significant increased risk of VTE among patients with CD with the pooled risk ratio of 1.25 (95% confidence interval, 1.02-1.53). The statistical heterogeneity was moderate with an I(2) of 69%.

Conclusions: A significantly increased risk of VTE among patients with CD was demonstrated in this meta-analysis. Further studies are required to clarify how this risk should be addressed in clinical practice.

Keywords: celiac disease; epidemiology; meta-analysis; venous thromboembolism.