{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T12:27:01Z","timestamp":1783945621340,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2017,2,20]],"date-time":"2017-02-20T00:00:00Z","timestamp":1487548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Duodenal injury persists in some coeliac disease patients despite gluten\u2010free diet, and is associated with adverse outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the prevalence and clinical risk factors for persistent villus atrophy among symptomatic coeliac disease patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A nested cross\u2010sectional analysis was performed on coeliac disease patients with self\u2010reported moderate or severe symptoms while following a gluten\u2010free diet, who underwent protocol\u2010mandated duodenal biopsy upon enrolment in the CeliAction clinical trial. Demographic factors, symptom type, medication use, and serology were examined to determine predictors of persistent villus atrophy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1345 symptomatic patients, 511 (38%, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 35\u201341%) were found to have active coeliac disease with persistent villus atrophy, defined as average villus height to crypt depth ratio \u22642.0. On multivariable analysis, older age (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 5.1 for \u226570 vs. 18\u201329 years, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 2.5\u201310.4) was a risk factor while longer duration on gluten\u2010free diet was protective (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 0.37, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.24\u20130.55 for 4\u20135.9 vs. 1\u20131.9 years). Villus atrophy was associated with use of proton\u2010pump inhibitors (<jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content>s; <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 1.6, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.1\u20132.3), non\u2010steroidal anti\u2010inflammatory drugs (<jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content>s; <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 1.64, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.2\u20132.2), and selective serotonin reuptake inhibitors (<jats:styled-content style=\"fixed-case\">SSRI<\/jats:styled-content>s; <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 1.74, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.2\u20132.5). Symptoms were not associated with villus atrophy after adjusting for covariates.<\/jats:p><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A majority of symptomatic coeliac disease patients did not have active disease on follow\u2010up histology. Symptoms were poorly predictive of persistent mucosal injury. The impact of <jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content>s, <jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content>s, and <jats:styled-content style=\"fixed-case\">SSRI<\/jats:styled-content>s on mucosal healing in coeliac disease warrants further study.<\/jats:p><\/jats:sec><\/jats:sec>","DOI":"10.1111\/apt.13988","type":"journal-article","created":{"date-parts":[[2017,2,21]],"date-time":"2017-02-21T17:04:00Z","timestamp":1487696640000},"page":"1084-1093","source":"Crossref","is-referenced-by-count":66,"title":["Factors associated with villus atrophy in symptomatic coeliac disease patients on a gluten\u2010free diet"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4123-3922","authenticated-orcid":false,"given":"S.","family":"Mahadev","sequence":"first","affiliation":[{"name":"Celiac Disease Center Columbia University College of Physicians and Surgeons New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. A.","family":"Murray","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology The Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.\u2010T.","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology The Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. S.","family":"Chandan","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology The Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. S.","family":"Torbenson","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology The Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. P.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Celiac Center Beth Israel Deaconess Medical Center and Celiac Research Program Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Maki","sequence":"additional","affiliation":[{"name":"Tampere Center for Child Health Research School of Medicine University of Tampere and Tampere University Hospital Finland Europe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. H. R.","family":"Green","sequence":"additional","affiliation":[{"name":"Celiac Disease Center Columbia University College of Physicians and Surgeons New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Adelman","sequence":"additional","affiliation":[{"name":"Division of Allergy\/Immunology Department of Medicine University of California San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Lebwohl","sequence":"additional","affiliation":[{"name":"Celiac Disease Center Columbia University College of Physicians and Surgeons New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,2,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra071600"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12621"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2006.10.004"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1309\/EVXT-851X-WHLC-RLX9"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.03992.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2007.03311.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.104"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-159-3-201308060-00006"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-3164"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12164"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.10"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.2007.02621.x"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365520802200044"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2015.04.002"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000370205"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2011.06.075"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2016.02.005"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.11.004"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2012.12.005"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2012.06.003"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12850"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00902.x"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2013.08.128"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(16)33015-3"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2008.03824.x"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1211\/0022357021778583"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1096\/fj.04-3170fje"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/81.1.154"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.10.022"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2015.155"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365520701452217"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2009.07.011"},{"key":"e_1_2_7_34_1","first-page":"473","article-title":"Serological tests for celiac disease as indicators of long\u2010term compliance with the gluten\u2010free diet","volume":"23","author":"Nachman F","year":"2011","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0000000000000392"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2010.07.014"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.13988","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.13988","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T16:48:38Z","timestamp":1695487718000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.13988"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2,20]]},"references-count":35,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2017,4]]}},"alternative-id":["10.1111\/apt.13988"],"URL":"https:\/\/doi.org\/10.1111\/apt.13988","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2,20]]}}}