Maria van der Pals, Anneli Ivarsson, Fredrik Norström, Lotta Högberg, Johan Svensson, Annelie Carlsson
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引用次数: 30
摘要
目标。研究表明,未经治疗的乳糜泻与其他自身免疫性疾病的风险之间存在相关性。我们调查了12岁儿童甲状腺自身免疫的患病率(1)诊断并使用无麸质饮食治疗的有症状的乳糜泻,(2)筛查发现的未治疗的乳糜泻,以及(3)没有乳糜泻。方法。收集了12632名儿童的血液样本。所有乳糜泻病例,既往诊断和新筛查发现,被确定。每个病例匹配4个参照物。分析血样中抗甲状腺过氧化物酶(TPOAb)的自身抗体。TPO阳性临界值设为100 U/mL。结果。总共发现了335例乳糜泻病例。在整个乳糜泻组中,7.2%(24/335)的参试者TPOAb滴度升高,而2.8%(48/1695)的参试者TPOAb滴度升高。在先前诊断的乳糜泻病例中,7.5% (7/93,OR 2.8, 95% CI 1.2-6.4)为TPOAb阳性,在筛查检测的病例中,7.0% (17/242,OR 2.6, 95% CI 1.5-4.6)为TPOAb阳性。结论。乳糜泻患儿甲状腺自身免疫的患病率较高。我们不能证实未经治疗的乳糜泻与甲状腺自身免疫风险增加有关的假设。早期开始治疗乳糜泻可能不会降低其他自身免疫性疾病的风险。
Prevalence of thyroid autoimmunity in children with celiac disease compared to healthy 12-year olds.
Objectives. Studies have suggested a correlation between untreated celiac disease and risk for other autoimmune diseases. We investigated the prevalence of thyroid autoimmunity in 12-year-old children (i) with symptomatic celiac disease diagnosed and treated with a gluten-free diet, (ii) with screening-detected untreated celiac disease, and (iii) without celiac disease. Methods. Blood samples from 12632 children were collected. All celiac disease cases, previously diagnosed and newly screening-detected, were identified. Per case, 4 referents were matched. Blood samples were analyzed for autoantibodies against thyroid peroxidase (TPOAb). The cut-off value for TPO positivity was set to 100 U/mL. Results. Altogether, 335 celiac disease cases were found. In the entire celiac disease group, 7.2% (24/335) had elevated titers of TPOAb compared to 2.8% (48/1695) of the referents. Among the previously diagnosed celiac disease cases, 7.5% (7/93, OR 2.8, 95% CI 1.2-6.4) was TPOAb positive and among screening-detected cases, 7.0% (17/242, OR 2.6, 95% CI 1.5-4.6) was TPOAb positive. Conclusion. Children with celiac disease showed a higher prevalence of thyroid autoimmunity. We could not confirm the hypothesis that untreated celiac disease is associated with increased risk of developing thyroid autoimmunity. Early initiation of celiac disease treatment might not lower the risk for other autoimmune diseases.