{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:54:29Z","timestamp":1787162069614,"version":"build-2736575974"},"reference-count":44,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T00:00:00Z","timestamp":1701043200000},"content-version":"unspecified","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Torben og Alice Frimodts Fund","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}]},{"name":"A.P. M\u00f8ller","award":["18-L-0032"],"award-info":[{"award-number":["18-L-0032"]}]},{"name":"A.P. M\u00f8ller","award":["19-L-0228"],"award-info":[{"award-number":["19-L-0228"]}]},{"name":"Odense Universitetshospital, research fund","award":["A3675 and A 2971"],"award-info":[{"award-number":["A3675 and A 2971"]}]},{"name":"Southern Denmark and Hans Christian Anderson Children\u2019s Hospital","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}]},{"name":"L.F. Foghts Fund","award":["21.844"],"award-info":[{"award-number":["21.844"]}]},{"name":"Augustinus Fund","award":["19-2419"],"award-info":[{"award-number":["19-2419"]}]},{"name":"Department of clinical immunology, Odense University Hospital","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}]},{"name":"Direkt\u00f8r Kurt B\u00f8nnelyckes og hustru Fru Grethe B\u00f8nnelyckes Fund","award":["100 53030"],"award-info":[{"award-number":["100 53030"]}]},{"name":"Thermo Fischer A\/S","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,10,19]]},"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Our aim was to investigate the association between early environmental factors and the development of coeliac disease (CeD) in adolescents, recruited from a cohort nested in the Danish National Birth Cohort (DNBC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>The study was designed as a prospective cohort study, nested in DNBC<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The Glutenfunen cohort comprises 1266 participants, nested in DNBC. All participants were screened for CeD, and in total, 28 cases of biopsy proven CeD were identified. Data about breastfeeding, timing of introduction to solid food in infancy, use of antibiotics, infections and symptoms were parentally reported prospectively at 6 months and 18 months, respectively. We estimated ORs and 95% CIs of CeD in adolescents using logistic regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Viral croup reported at 18 months of age was associated with CeD in adolescents with an OR of 3.2 (95% CI: 1.2 to 8.7). Furthermore, otitis media also reported at 18 months of age was linked with CeD with an OR of 3.2 (95% CI: 1.5 to 7.3). We were not able to find any statistical associations between CeD and breastfeeding, frequency of infections, parentally reported use of antibiotic and timing of solid foods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this study, we present an overview of the relationship between early environmental factors and occurrence of CeD in adolescents. Our findings, despite limitations due to a limited number of cases of CeD, suggest a role of viral infections in the pathogenesis of CeD<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-061006","type":"journal-article","created":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T12:49:37Z","timestamp":1701089377000},"page":"e061006","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Early environmental risk factors and coeliac disease in adolescents: a population-based cohort study in Denmark"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7526-8843","authenticated-orcid":false,"given":"C\u00e6cilie","family":"Crawley","sequence":"first","affiliation":[{"name":"Department of Clinical Research, University of Southern Denmark, Odense, Denmark"},{"name":"Hans Christian Anderson Children's Hospital, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stine Dydensborg","family":"Sander","sequence":"additional","affiliation":[{"name":"Hans Christian Anderson Children's Hospital, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen Aagaard","family":"Nohr","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, University of Southern Denmark, Odense, Denmark"},{"name":"Research Unit of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4296-8488","authenticated-orcid":false,"given":"Anne-Marie","family":"Nybo Andersen","sequence":"additional","affiliation":[{"name":"Institute of Public Health, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Husby","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, University of Southern Denmark, Odense, Denmark"},{"name":"Hans Christian Anderson Children's Hospital, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,11,27]]},"reference":[{"key":"2025121604543498000_13.11.e061006.1","doi-asserted-by":"publisher","DOI":"10.1126\/science.aay3037"},{"key":"2025121604543498000_13.11.e061006.2","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e31821a23d0"},{"key":"2025121604543498000_13.11.e061006.3","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1016\/j.autrev.2018.05.013","article-title":"Celiac disease and endocrine Autoimmunity - the genetic link","volume":"17","author":"Kahaly","year":"2018","journal-title":"Autoimmun Rev"},{"key":"2025121604543498000_13.11.e061006.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmed.2010.09.003"},{"key":"2025121604543498000_13.11.e061006.5","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/j.cgh.2017.06.037","article-title":"Global prevalence of celiac disease: systematic review and meta-analysis","volume":"16","author":"Singh","year":"2018","journal-title":"Clinical Gastroenterology and Hepatology"},{"key":"2025121604543498000_13.11.e061006.6","doi-asserted-by":"publisher","DOI":"10.1080\/080352500750028771"},{"key":"2025121604543498000_13.11.e061006.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1404172"},{"key":"2025121604543498000_13.11.e061006.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1400697"},{"key":"2025121604543498000_13.11.e061006.9","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1093\/ajcn\/75.5.914","article-title":"Breast-feeding protects against celiac disease","volume":"75","author":"Ivarsson","year":"2002","journal-title":"Am J Clin Nutr"},{"key":"2025121604543498000_13.11.e061006.10","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-1752"},{"key":"2025121604543498000_13.11.e061006.11","doi-asserted-by":"publisher","DOI":"10.1126\/science.aah5298"},{"key":"2025121604543498000_13.11.e061006.12","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2020.604529","article-title":"Enterovirus infections are associated with the development of celiac disease in a birth cohort study","volume":"11","author":"Oikarinen","year":"2020","journal-title":"Front Immunol"},{"key":"2025121604543498000_13.11.e061006.13","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2019-319809"},{"key":"2025121604543498000_13.11.e061006.14","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.l231","article-title":"Enterovirus as trigger of Coeliac disease: nested case-control study within prospective birth cohort","volume":"364","author":"Kahrs","year":"2019","journal-title":"BMJ"},{"key":"2025121604543498000_13.11.e061006.15","doi-asserted-by":"publisher","DOI":"10.1080\/140349401317115268"},{"key":"2025121604543498000_13.11.e061006.16","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyl170"},{"key":"2025121604543498000_13.11.e061006.17","unstructured":"Dydensborg Sander S , Hansen AV , St\u00f8rdal K , et al . Mode of delivery is not associated with celiac disease"},{"key":"2025121604543498000_13.11.e061006.18","doi-asserted-by":"crossref","first-page":"2217","DOI":"10.1053\/j.gastro.2019.02.039","article-title":"Association between antibiotics in the first year of life and celiac disease","volume":"156","author":"Dydensborg Sander","year":"2019","journal-title":"Gastroenterology"},{"key":"2025121604543498000_13.11.e061006.19","doi-asserted-by":"publisher","DOI":"10.1080\/00365529850172368"},{"key":"2025121604543498000_13.11.e061006.20","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000737"},{"key":"2025121604543498000_13.11.e061006.21","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.11.043"},{"key":"2025121604543498000_13.11.e061006.22","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1447.062"},{"key":"2025121604543498000_13.11.e061006.23","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1097\/MPG.0000000000003247","article-title":"High prevalence of celiac disease among Danish adolescents - A population-based study","volume":"74","author":"Crawley","year":"2022","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2025121604543498000_13.11.e061006.24","doi-asserted-by":"publisher","DOI":"10.1016\/S0753-3322(01)80003-2"},{"key":"2025121604543498000_13.11.e061006.25","unstructured":"Marsh MN . n.d. Gluten, major Histocompatibility complex, and the small intestine. A molecular and Immunobiologic approach to the spectrum of gluten sensitivity ('celiac sprue'). (0016-5085 (print))."},{"key":"2025121604543498000_13.11.e061006.26","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"2025121604543498000_13.11.e061006.27","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1111\/apt.16161","article-title":"Review article: exposure to Microbes and risk of Coeliac disease","volume":"53","author":"St\u00f8rdal","year":"2021","journal-title":"Aliment Pharmacol Ther"},{"key":"2025121604543498000_13.11.e061006.28","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.dld.2016.10.009","article-title":"\u201cReply to \"antibiotics, intestinal Dysbiosis and risk of celiac disease\" by Hakim Rahmoune et al\u201d","volume":"49","author":"Simre","year":"2017","journal-title":"Digestive and Liver Disease"},{"key":"2025121604543498000_13.11.e061006.29","doi-asserted-by":"crossref","unstructured":"Tapia G , Chud\u00e1 K , Kahrs CR , et al . Parechovirus infection in early childhood and association with subsequent celiac disease. Gastroenterology [Preprint] 2020. doi:10.1101\/2020.04.28.20082024","DOI":"10.1101\/2020.04.28.20082024"},{"key":"2025121604543498000_13.11.e061006.30","unstructured":"Stene LC , Honeyman Mc Fau - Hoffenberg EJ , Hoffenberg Ej Fau - Haas JE , et al . n.d. Rotavirus infection frequency and risk of celiac disease Autoimmunity in early childhood: a longitudinal study. (0002-9270 (print))."},{"key":"2025121604543498000_13.11.e061006.31","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1097\/INF.0000000000002281","article-title":"Rotavirus vaccination does not increase type 1 diabetes and may decrease celiac disease in children and adolescents","volume":"38","author":"Hemming-Harlo","year":"2019","journal-title":"Pediatr Infect Dis J"},{"key":"2025121604543498000_13.11.e061006.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2007.10.043"},{"key":"2025121604543498000_13.11.e061006.33","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1007\/s10620-014-3046-1","article-title":"Children with celiac disease are more likely to have attended hospital for prior respiratory syncytial virus infection","volume":"59","author":"Tjernberg","year":"2014","journal-title":"Dig Dis Sci"},{"key":"2025121604543498000_13.11.e061006.34","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1080\/00365521.2017.1362464","article-title":"Influenza and risk of later celiac disease: a cohort study of 2.6 million people","volume":"53","author":"K\u00e5rhus","year":"2018","journal-title":"Scand J Gastroenterol"},{"key":"2025121604543498000_13.11.e061006.35","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.1007\/s00125-017-4365-5","article-title":"Respiratory infections are temporally associated with initiation of type 1 diabetes Autoimmunity: the TEDDY study","volume":"60","author":"L\u00f6nnrot","year":"2017","journal-title":"Diabetologia"},{"key":"2025121604543498000_13.11.e061006.36","doi-asserted-by":"publisher","DOI":"10.1542\/peds.102.2.291"},{"key":"2025121604543498000_13.11.e061006.37","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.1111\/apa.14791","article-title":"Early-life exposure to common virus infections did not differ between coeliac disease patients and controls","volume":"108","author":"Simre","year":"2019","journal-title":"Acta Paediatr"},{"key":"2025121604543498000_13.11.e061006.38","doi-asserted-by":"publisher","DOI":"10.1136\/gut.28.8.995"},{"key":"2025121604543498000_13.11.e061006.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2018.09.004"},{"key":"2025121604543498000_13.11.e061006.40","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13163"},{"key":"2025121604543498000_13.11.e061006.41","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-0438"},{"key":"2025121604543498000_13.11.e061006.42","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-010-9448-2"},{"key":"2025121604543498000_13.11.e061006.43","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2015.287"},{"key":"2025121604543498000_13.11.e061006.44","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.10329"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2022-061006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:54:47Z","timestamp":1765889687000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2022-061006"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11]]},"references-count":44,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11,27]]},"published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1136\/bmjopen-2022-061006"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2022-061006","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11]]}}}