Assa Amit, Frenkel-Nir Yael, Tzur Dorit, Katz Lior H, Shamir Raanan
Institute of Gastroenterology, Nutrition and Liver Disease, Schneider Children's Medical Center, Petach Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Acta Paediatr. 2017 Jun;106(6):967-972. doi: 10.1111/apa.13808. Epub 2017 Apr 2.
Celiac disease (CD) is a systemic disorder that is associated with various autoimmune disorders and a higher prevalence of other diagnoses and complications. This large, cross-sectional, population-based study investigated the associations between CD and various medical conditions during late adolescence.
We included 2 001 353 Jewish Israeli adolescents who underwent a general health examination at a median age of 17.1 (16.9-17.4) years from 1988 to 2015. Comprehensive data regarding medical status were available for 1 588 041 (79%) subjects. A definite diagnosis of CD was based on accepted criteria. Covariate data included demographic measures and data on associated medical conditions.
Overall, data on 7145 subjects with CD and 1 580 896 controls were analysed. Multivariate analyses showed that autoimmune diseases were significantly more common in subjects with CD, including insulin dependent diabetes, with an odds ratio (OR) of 5.5, inflammatory bowel diseases (OR = 3.8), arthritis (OR = 2.4), thyroid diseases (OR = 1.8) and psoriatic skin disorders (OR = 1.6). Further associations included asthma (OR = 1.5), bile stones (OR = 3.6), migraine (OR = 2.3), anaemia (OR = 1.7) and menstrual abnormalities (OR = 1.5). Long bone fractures and axial fractures were no more common in adolescents with CD than controls.
CD was already associated with multiple comorbidities by adolescence, and these were not limited to autoimmune disorders.
乳糜泻（CD）是一种全身性疾病，与多种自身免疫性疾病以及其他诊断和并发症的较高患病率相关。这项大型的、基于人群的横断面研究调查了青春期后期CD与各种疾病之间的关联。
我们纳入了1988年至2015年期间接受一般健康检查的2001353名以色列犹太青少年，他们的中位年龄为17.1（16.9 - 17.4）岁。1588041名（79%）受试者有关于医疗状况的全面数据。CD的明确诊断基于公认标准。协变量数据包括人口统计学指标和相关医疗状况的数据。
总体而言，分析了7145名CD患者和1580896名对照的数据。多变量分析显示，自身免疫性疾病在CD患者中显著更常见，包括胰岛素依赖型糖尿病，优势比（OR）为5.5，炎症性肠病（OR = 3.8），关节炎（OR = 2.4），甲状腺疾病（OR = 1.8）和银屑病性皮肤病（OR = 1.6）。其他关联包括哮喘（OR = 1.5），胆结石（OR = 3.6），偏头痛（OR = 2.3），贫血（OR = 1.7）和月经异常（OR = 1.5）。长骨骨折和轴向骨折在CD青少年中并不比对照组更常见。
到青春期时，CD就已经与多种合并症相关，且这些合并症并不局限于自身免疫性疾病。
