Canova Cristina, Pitter Gisella, Ludvigsson Jonas F, Romor Pierantonio, Zanier Loris, Zanotti Renzo, Simonato Lorenzo
Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padua, Padua, Italy.
Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padua, Padua, Italy.
J Pediatr. 2016 Jul;174:146-152.e1. doi: 10.1016/j.jpeds.2016.02.058. Epub 2016 Mar 24.
To estimate the relative risk of developing type 1 diabetes mellitus (T1DM) and autoimmune thyroid disease in children with celiac disease (CD).
A matched cohort design with linkage of administrative data was adopted. A total of 1215 cases of CD and 6075 references matched by sex and year of birth born in Friuli Venezia Giulia Region (Italy) between 1989 and 2011 were included. Cox regression models were used to estimate hazard ratios (HRs) for autoimmune diseases in patients with CD compared with references, stratified by sex and age at diagnosis.
Individuals with CD had an increased risk of subsequent hypothyroidism (HR 4.64 [95% CI 2.88-7.46]) and T1DM (HR 2.50 [95% CI 0.94-6.66]), the latter not statistically significant. Risk of hypothyroidism was higher in males (HR 20.00; 95% CI 5.64-70.87) than females (HR 3.21; 95% CI 1.85-5.57) (P value <.01). No differences were observed between males and females risks for diabetes or age at CD diagnosis. The small number of hyperthyroidism cases identified precluded any statistical analysis.
Children and youth with CD are at increased risk of developing autoimmune hypothyroidism and to some extent T1DM. This suggests the need for surveillance of children with CD in order to timely detect the onset of such comorbidities.
评估乳糜泻（CD）患儿患1型糖尿病（T1DM）和自身免疫性甲状腺疾病的相对风险。
采用行政数据链接的匹配队列设计。纳入了1989年至2011年在意大利弗留利-威尼斯朱利亚大区出生的1215例CD患儿及6075例按性别和出生年份匹配的对照。使用Cox回归模型估计CD患儿与对照相比患自身免疫性疾病的风险比（HRs），并按诊断时的性别和年龄分层。
CD患儿患随后甲状腺功能减退症的风险增加（HR 4.64 [95% CI 2.88 - 7.46]），患T1DM的风险增加（HR 2.50 [95% CI 0.94 - 6.66]），后者无统计学意义。男性患甲状腺功能减退症的风险（HR 20.00；95% CI 5.64 - 70.87）高于女性（HR 3.21；95% CI 1.85 - 5.57）（P值 <.01）。男性和女性患糖尿病的风险以及CD诊断时的年龄之间未观察到差异。所识别的甲状腺功能亢进症病例数量较少，无法进行任何统计分析。
患有CD的儿童和青少年患自身免疫性甲状腺功能减退症的风险增加，在一定程度上患T1DM的风险也增加。这表明需要对CD患儿进行监测，以便及时发现此类合并症的发病情况。
