European Journal of Epidemiology

, Volume 21, Issue 5, pp 359–365

Mortality Excess in Individuals with Elevated IgA Anti-Transglutaminase Antibodies: The KORA/MONICA Augsburg Cohort Study 1989–1998

  • Marie-Hélène Metzger
  • Margit Heier
  • Markku Mäki
  • Enzo Bravi
  • Andrea Schneider
  • Hannelore Löwel
  • Thomas Illig
  • Detlef Schuppan
  • Heinz-Erich Wichmann
Article

DOI: 10.1007/s10654-006-9002-4

Cite this article as:
Metzger, MH., Heier, M., Mäki, M. et al. Eur J Epidemiol (2006) 21: 359. doi:10.1007/s10654-006-9002-4

Abstract

Objectives

: Immunoglobulin A (IgA) autoantibodies to tissue transglutaminase (tTG) are commonly used for screening and diagnosing of celiac disease. We examined the hypothesis that elevated IgA anti-tTG antibodies were associated with higher all-cause mortality risk.

Methods

The cohort, 2333 men and 2300 women, was based on the follow-up of participants of a representative population-based survey in Southern Germany (KORA/MONICA Augsburg project) conducted in 1989–1990. The endpoint for the vital status with cause of death was the year 1998. The sera drawn at baseline and stored at −80 °C, were recently screened with an IgA enzyme-linked immunosorbent assay (ELISA) using human recombinant tTG. Age-standardized mortality rates and age-adjusted hazard ratios were calculated.

Results

From the 4633 sera analyzed, 63 had an IgA anti-tTG concentration ≥7 AU/ml. Of these 63 individuals, 15 died between 1989 and 1998. The age-adjusted hazard ratio (HRa) of all-cause mortality was 1.86 (95% CI: 1.01–3.41) and 3.92 (95% CI: 1.44–10.71) for men and women, respectively. The excess of cancer mortality was even higher with an HRa of 2.47 (95% CI: 0.89–6.83) in men and of 6.65 (95% CI: 2.04–21.63) in women.

Conclusions:

Individuals with elevated IgA anti-tTG antibodies had a highly increased mortality risk, particularly due to cancer. New studies are necessary to clarify if this increased risk is due to undiagnosed celiac disease or/and if this elevated IgA anti-tTG antibodies level is a marker of serious diseases like cancer, chronic liver disease or end-stage heart failure.

Keywords

Celiac diseaseCohort studiesMortalityNeoplasmsTissue transglutaminase

Copyright information

© Springer 2006

Authors and Affiliations

  • Marie-Hélène Metzger
    • 1
  • Margit Heier
    • 1
  • Markku Mäki
    • 2
  • Enzo Bravi
    • 3
  • Andrea Schneider
    • 1
  • Hannelore Löwel
    • 1
  • Thomas Illig
    • 1
  • Detlef Schuppan
    • 4
    • 5
  • Heinz-Erich Wichmann
    • 1
  1. 1.GSF – National Research Center for Environment and HealthInstitute of EpidemiologyNeuherbergGermany
  2. 2.Medical School – Pediatric Research CentreUniversity of TampereTampereFinland
  3. 3.EurospitalTriesteItaly
  4. 4.Med. Clinic IUniversity of Erlangen–NuernbergErlangenGermany
  5. 5.Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonUSA
  6. 6.GSF – National Research Center for Environment and HealthInstitute of EpidemiologyNeuherbergGermany