. 2024 Jan 9;14(1):e077131.

doi: 10.1136/bmjopen-2023-077131.

Coeliac disease in the Trøndelag Health Study (HUNT), Norway, a population-based cohort of coeliac disease patients

Polina Lukina¹, Ina Lervåg Andersen^{2

3}, Petter Tinbod Eggen³, Patricia Gjertrud Mjønes^{4

5}, Elin Rønne⁵, Nils Bolstad⁶, Rolf Anton Klaasen⁶, David J Warren⁶, Rasmus Iversen⁷, Kristian Hveem^{2

8}, Tomm Bernklev^{9

10}, Lars Petter Jelsness-Jørgensen^{11

12}, Lise Pedersen¹³, Iris Jonkers¹⁴, Pernilla Lagergren^{15

16}, Ludvig Magne Sollid^{7

17}, Knut Lundin^{7

18}, Eivind Ness-Jensen^{2

3

15}

Affiliations

¹ HUNT Research Centre, Norwegian University of Science and Technology, Levanger, Norway polina.lukina@ntnu.no.
² HUNT Research Centre, Norwegian University of Science and Technology, Levanger, Norway.
³ Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
⁴ Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Trøndelag, Norway.
⁵ Department of Pathology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Trøndelag, Norway.
⁶ Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.
⁷ K.G. Jebsen Centre for Coeliac Disease Research, University of Oslo, Oslo, Norway.
⁸ K.G. Jebsen Centre for Genetic Epidemiology, Norwegian University of Science and Technology, Trondheim, Trøndelag, Norway.
⁹ Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
¹⁰ R&D Department, Vestfold Hospital Trust, Tønsberg, Vestfold, Norway.
¹¹ Østfold University College, Halden, Østfold, Norway.
¹² Department of Gastroenterology, Østfold Hospital Trust, Kalnes, Norway.
¹³ Norwegian Coeliac Society, Oslo, Norway.
¹⁴ Department of Genetics, University of Groningen, Groningen, Groningen, The Netherlands.
¹⁵ Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Stockholm, Sweden.
¹⁶ Department of Surgery and Cancer, Imperial College London, London, UK.
¹⁷ Department of Immunology, Oslo University Hospital, Oslo, Norway.
¹⁸ Department of Gastroenterology, Oslo University Hospital, Oslo, Norway.

PMID: 38195172
PMCID: PMC10806793
DOI: 10.1136/bmjopen-2023-077131

Coeliac disease in the Trøndelag Health Study (HUNT), Norway, a population-based cohort of coeliac disease patients

Polina Lukina et al. BMJ Open. 2024.

. 2024 Jan 9;14(1):e077131.

doi: 10.1136/bmjopen-2023-077131.

Authors

Affiliations

¹ HUNT Research Centre, Norwegian University of Science and Technology, Levanger, Norway polina.lukina@ntnu.no.
² HUNT Research Centre, Norwegian University of Science and Technology, Levanger, Norway.
³ Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
⁴ Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Trøndelag, Norway.
⁵ Department of Pathology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Trøndelag, Norway.
⁶ Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.
⁷ K.G. Jebsen Centre for Coeliac Disease Research, University of Oslo, Oslo, Norway.
⁸ K.G. Jebsen Centre for Genetic Epidemiology, Norwegian University of Science and Technology, Trondheim, Trøndelag, Norway.
⁹ Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
¹⁰ R&D Department, Vestfold Hospital Trust, Tønsberg, Vestfold, Norway.
¹¹ Østfold University College, Halden, Østfold, Norway.
¹² Department of Gastroenterology, Østfold Hospital Trust, Kalnes, Norway.
¹³ Norwegian Coeliac Society, Oslo, Norway.
¹⁴ Department of Genetics, University of Groningen, Groningen, Groningen, The Netherlands.
¹⁵ Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Stockholm, Sweden.
¹⁶ Department of Surgery and Cancer, Imperial College London, London, UK.
¹⁷ Department of Immunology, Oslo University Hospital, Oslo, Norway.
¹⁸ Department of Gastroenterology, Oslo University Hospital, Oslo, Norway.

PMID: 38195172
PMCID: PMC10806793
DOI: 10.1136/bmjopen-2023-077131

Abstract

Purpose: Coeliac disease (CD) is a common disorder and affects about 1% of the population worldwide. CD in the Trøndelag Health Study (HUNT) is a population-based cohort study which was established to provide new knowledge about CD that can improve the diagnostics and management, prevent the onset or progression and expand the knowledge about the role of genetics of the disease.

Participants: The cohort is based on the fourth wave of the population-based HUNT study (HUNT4), Norway, performed during 2017-2019, also including linkage to hospital records and the Norwegian Patient Registry (NPR). A total of 54 541 HUNT4 participants with available sera were screened for CD by serology. All seropositive participants were invited to a clinical assessment, including endoscopy with duodenal biopsies, during 2019-2023.

Findings to date: A total of 1107 HUNT4 participants (2%) were seropositive for CD and 1048 were eligible for clinical assessment, including biopsy. Of these, 724 participants attended the clinical assessment and 482 were identified with CD. In addition, 371 participants with CD were identified through the hospital records and NPR. In total, 853 participants in HUNT4 with biopsy-verified CD diagnosis were identified.

Future plans: All participants in the study will be invited to a follow-up assessment after at least 1 year, including repeated standard serological testing, endoscopy and tissue sampling. The collected data and material will be used to establish the true population-based prevalence of CD. The consequences of CD, including symptoms, deficiencies and comorbidity, will be investigated and possible triggers and predictors, will be studied. With access to serum samples from the previous HUNT surveys in HUNT Biobank, serological signs of CD in prediagnostic samples of seropositive individuals will be used. Genetic studies will identify new CD markers, assess genotype-phenotype links and explore gene-environment correlations.

Registration: clinicaltrials.gov identifier: NCT04041622.

Keywords: Coeliac disease; EPIDEMIOLOGIC STUDIES; EPIDEMIOLOGY; REGISTRIES.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

**Figure 1**
The former Nord-Trøndelag County, the Trøndelag Health Study’s geographic area (the Norwegian Mapping Authority, Kartverket).

**Figure 2**
Number (n) of participants in each stage of the establishment of the coeliac disease cohort in the Trøndelag Health Study. ^aDead, moved or refused consent.

See this image and copyright information in PMC

References

1. Ludvigsson JF, Leffler DA, Bai JC, et al. . The Oslo definitions for coeliac disease and related terms. Gut 2013;62:43–52. 10.1136/gutjnl-2011-301346 - DOI - PMC - PubMed
1. Biesiekierski JR. What is gluten J Gastroenterol Hepatol 2017;32 Suppl 1:78–81. 10.1111/jgh.13703 - DOI - PubMed
1. Sollid LM. Coeliac disease: Dissecting a complex inflammatory disorder. Nat Rev Immunol 2002;2:647–55. 10.1038/nri885 - DOI - PubMed
1. Green PHR. The many faces of celiac disease: clinical presentation of celiac disease in the adult population. Gastroenterology 2005;128(4 Suppl 1):S74–8. 10.1053/j.gastro.2005.02.016 - DOI - PubMed
1. Makharia GK, Singh P, Catassi C, et al. . The global burden of Coeliac disease: opportunities and challenges. Nat Rev Gastroenterol Hepatol 2022;19:313–27. 10.1038/s41575-021-00552-z - DOI - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions

Associated data

Actions
- Search in PubMed
- Search in ClinicalTrials.gov

LinkOut - more resources

Full Text Sources
- Europe PubMed Central

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Coeliac disease in the Trøndelag Health Study (HUNT), Norway, a population-based cohort of coeliac disease patients

Affiliations

Coeliac disease in the Trøndelag Health Study (HUNT), Norway, a population-based cohort of coeliac disease patients

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Associated data

LinkOut - more resources

Full Text Sources