Department of Gastroenterology and Hepatology, Faculties of Medicine and Health and Behavioral Sciences, Translational Research Institute, Princess Alexandra Hospital, University of Queensland, Brisbane, Qld.
Faculty of Health and Medicine, University of Newcastle, Newcastle.
J Clin Gastroenterol. 2019 Aug;53(7):514-522. doi: 10.1097/MCG.0000000000001033.
The aim of this analysis was to assess in patients with inflammatory bowel disease (IBD) the risk of celiac disease and in celiac disease patients the risk of IBD.
Previous studies report a possible association between IBD and celiac disease; however, this link is controversial.
Using the search terms "inflammatory bowel disease" and "celiac disease," we identified initially 1525 publications. In total 27 studies met inclusion criteria. Proportions and 95% confidence intervals (CIs) for the prevalence of IBD in celiac disease and vice versa were compared with published prevalence rates for the respective geographic regions.
We included 41,482 adult IBD patients (20,357 with Crohn's disease; 19,791 with ulcerative colitis; and 459 patients with celiac disease). Overall, in IBD patients the prevalence of celiac disease was 1110/100,000 (95% CI, 1010-1210/100,000) as compared with a prevalence of 620/100,000 (95% CI, 610-630/100,000) in the respective populations (odds ratio, 2.23; 95% CI, 1.99-2.50). In contrast, in patients with celiac disease, 2130/100,000 had IBD (95% CI, 1590-2670/100,000) as compared with 260/100,000 (95% CI, 250/100,000-270/100,000) in the respective populations (odds ratio, 11.10; 95% CI, 8.55-14.40). This effect was not different for ulcerative colitis and Crohn's disease. Although there was no evidence for publication bias for celiac disease in IBD, the funnel plot suggested that the association between IBD in celiac disease might be influenced by publication bias.
The data are consistent with the notion that celiac disease is a risk factor for IBD and to lesser degree patients with IBD have an increased risk of celiac disease.
本分析旨在评估炎症性肠病（IBD）患者中乳糜泻的风险，以及乳糜泻患者中 IBD 的风险。
先前的研究报告称 IBD 与乳糜泻之间可能存在关联；然而，这种联系存在争议。
使用“炎症性肠病”和“乳糜泻”这两个检索词，我们最初确定了 1525 篇文献。共有 27 项研究符合纳入标准。比较了乳糜泻患者中 IBD 的患病率和反之亦然，以及各自地理区域的已发表患病率。
我们纳入了 41482 名成年 IBD 患者（20357 名克罗恩病患者；19791 名溃疡性结肠炎患者；459 名乳糜泻患者）。总体而言，在 IBD 患者中，乳糜泻的患病率为 1110/100000（95%CI，1010-1210/100000），而相应人群中的患病率为 620/100000（95%CI，610-630/100000）（比值比，2.23；95%CI，1.99-2.50）。相反，在乳糜泻患者中，100000 中有 2130 人患有 IBD（95%CI，1590-2670/100000），而相应人群中为 260/100000（95%CI，250/100000-270/100000）（比值比，11.10；95%CI，8.55-14.40）。这种影响在溃疡性结肠炎和克罗恩病中没有差异。虽然乳糜泻的 IBD 中没有证据表明存在发表偏倚，但漏斗图表明乳糜泻中 IBD 的关联可能受到发表偏倚的影响。
这些数据与乳糜泻是 IBD 的危险因素的观点一致，并且程度较轻的是，IBD 患者患乳糜泻的风险增加。
