Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital and Karolinska Institutet, Karolinska, Sweden.
BMC Gastroenterol. 2013 May 16;13:89. doi: 10.1186/1471-230X-13-89.
Case reports and case series studies suggest a positive association between intussusception and celiac disease (CD).
We contacted Sweden's 28 pathology departments and obtained data on 29,096 patients with biopsy-verified CD (equal to Marsh stage 3) through biopsy reports. Patients with CD were matched for age, sex, calendar period and county of residence with up to five reference individuals from the general population (n=144,522). Cases of intussusception were identified from nationwide inpatient, hospital-based outpatient and day-surgery data from the Swedish Patient Register.Odds ratios (ORs) for future CD in patients with intussusception were estimated using conditional logistic regression.
34 (0.12%) individuals with CD had a diagnosis of intussusception vs. 143 (0.10%) reference individuals, suggesting that intussusception was not a risk factor for later CD (OR=1.17; 95% confidence interval (CI)=0.82-1.67). The OR for CD in patients with at least two records of intussusception was 0.40 (95% CI=0.06-2.99).In contrast, a post-hoc analysis showed that CD was associated with a statistically significantly increased risk of intussusception after CD diagnosis (hazard ratio=1.95; 95% CI=1.01-3.77); however, this analysis was based on only 12 cases with both CD and intussusception.
We found no association between intussusception and future CD; and a mostly modest increased risk of intussusception after a diagnosis of CD.
病例报告和病例系列研究表明，肠套叠与乳糜泻（CD）之间存在正相关关系。
我们联系了瑞典的 28 个病理部门，并通过活检报告获得了 29096 名经活检证实的 CD（等于 Marsh 阶段 3）患者的数据。CD 患者按年龄、性别、日历期和居住地与来自普通人群的最多 5 名对照个体（n=144522）相匹配。肠套叠病例是从瑞典患者登记处的全国住院、基于医院的门诊和日间手术数据中确定的。使用条件逻辑回归估计肠套叠患者未来发生 CD 的比值比（OR）。
34 名（0.12%）CD 患者被诊断为肠套叠，而 143 名（0.10%）对照个体，这表明肠套叠不是 CD 的危险因素（OR=1.17；95%置信区间（CI）=0.82-1.67）。至少有两次肠套叠记录的患者发生 CD 的 OR 为 0.40（95%CI=0.06-2.99）。相反，事后分析显示，在 CD 诊断后，CD 与肠套叠的发生风险呈统计学显著增加相关（风险比=1.95；95%CI=1.01-3.77）；然而，这项分析仅基于 12 例同时患有 CD 和肠套叠的患者。
我们没有发现肠套叠与未来 CD 之间存在关联；并且在 CD 诊断后肠套叠的风险略有增加。
