Ludvigsson J F, Wahlstrom J, Grunewald J, Ekbom A, Montgomery S M
Department of Paediatrics, Orebro University Hospital, Sweden.
Thorax. 2007 Jan;62(1):23-8. doi: 10.1136/thx.2006.059451. Epub 2006 Oct 17.
Coeliac disease (CD) is an autoimmune disease often characterised by malnutrition and linked to a number of complications such as an increased risk of lymphoma, adverse pregnancy outcome, and other autoimmune diseases. Tuberculosis (TB) affects a large proportion of the world population and is more common in individuals with malnutrition. We investigated the risk of TB in 14 335 individuals with CD and 69 888 matched reference individuals in a general population based cohort study.
Cox proportional hazards method was used to calculate the risk of subsequent TB in individuals with CD. In a separate analysis, the risk of CD in individuals with prior TB was calculated using conditional logistic regression.
CD was associated with an increased risk of subsequent TB (hazard ratio (HR) 3.74, 95% CI 2.14 to 6.53; p < 0.001). Similar risk estimates were seen when the population was stratified for sex and age at CD diagnosis. Individuals with CD were also at increased risk of TB diagnosed in departments of pulmonary medicine, infectious diseases, paediatrics, or thoracic medicine (HR 4.76, 95% CI 2.23 to 10.16; p < 0.001). The odds ratio for CD in individuals with prior TB was 2.50 (95% CI 1.75 to 3.55; p < 0.001).
CD is associated with TB. This may be due to malabsorption and lack of vitamin D in persons with CD. Individuals with TB and gastrointestinal symptoms should be investigated for CD.
乳糜泻（CD）是一种自身免疫性疾病，常表现为营养不良，并与多种并发症相关，如淋巴瘤风险增加、不良妊娠结局及其他自身免疫性疾病。结核病（TB）影响着世界上很大一部分人口，在营养不良的个体中更为常见。在一项基于人群的队列研究中，我们调查了14335例CD患者和69888例匹配的对照个体患TB的风险。
采用Cox比例风险法计算CD患者后续发生TB的风险。在另一项分析中，使用条件逻辑回归计算既往患TB个体患CD的风险。
CD与后续发生TB的风险增加相关（风险比（HR）3.74，95%可信区间2.14至6.53；p<0.001）。按CD诊断时的性别和年龄对人群进行分层时，得到了类似的风险估计值。CD患者在肺病科、传染病科、儿科或胸科被诊断出患TB的风险也增加（HR 4.76，95%可信区间2.23至10.
