The Division of Gastroenterology, Rabin Medical Center, Petach Tikva, Israel.
Clalit Research Institute, Innovation Division, Tel-Aviv, Israel.
Am J Gastroenterol. 2022 Sep 1;117(9):1428-1436. doi: 10.14309/ajg.0000000000001872. Epub 2022 Jun 15.
We evaluated whether persistent-positive celiac serology is associated with the risk of hypothyroidism.
We extracted a cohort of subjects aged 1-80 years with a positive IgA anti-tissue transglutaminase between January 1, 2008, and December 31, 2012, and a repeat anti-tissue transglutaminase test within 6-36 months from a large population-based electronic medical record database. Based on serology tests, we categorized the pediatric (age <21 years) and adult cohorts into normalized or persistent-positive serology groups. All subjects were followed up for incident diagnosis of hypothyroidism from the last serology date up to December 31, 2017. Hazard ratio (HR) along 95% confidence intervals (CIs) were prepared to evaluate the association of celiac serology group with a diagnosis of hypothyroidism, crude, and adjusted for age, sex, and diagnosis of type 1 diabetes mellitus.
Among the pediatric cohort (n = 2,687), during a median follow-up of 64 months (interquartile range 48-80), 2.3% (16/681) of the persistent-positive serology group and 1.0% (20/2,006) of the normalized serology group developed hypothyroidism (HR 2.07 [95% CI 1.07-4.44], adjHR 1.77 [95% CI 0.91-3.46]). The rate among the pediatric cohort with an established diagnosis of celiac disease was 3.4% (10/486) vs 1.0% (5/481), HR 2.83 (0.96-8.32). In the adult cohort (n = 1,286), 4.5% (20/442) of the persistent-positive group and 3.9% (33/811) of the normalized serology group developed hypothyroidism (HR 1.13 [95% CI 0.65-1.97]).
In this retrospective, age-stratified analysis, we report that persistent-positive serology may be associated with the risk of hypothyroidism among the pediatric population. Prospective cohorts are needed to validate our findings.
本研究旨在评估持续性阳性的麸质肠病血清学是否与甲状腺功能减退症的风险相关。
我们从一个大型基于人群的电子病历数据库中提取了 2008 年 1 月 1 日至 2012 年 12 月 31 日期间 IgA 抗组织转谷氨酰胺酶阳性且在 6-36 个月内进行重复抗组织转谷氨酰胺酶检测的 1-80 岁受试者队列。基于血清学检测，我们将儿科（年龄＜21 岁）和成年队列分为正常或持续性阳性血清学组。所有受试者从最后一次血清学日期起至 2017 年 12 月 31 日随访，记录甲状腺功能减退症的新发诊断。风险比（HR）及其 95%置信区间（CI）用于评估麸质肠病血清学组与甲状腺功能减退症的诊断、未校正年龄、性别和 1 型糖尿病诊断以及校正年龄、性别和 1 型糖尿病诊断的相关性。
在儿科队列（n=2687）中，中位随访 64 个月（四分位距 48-80）期间，持续性阳性血清学组中有 2.3%（16/681）和正常血清学组中有 1.0%（20/2006）发生甲状腺功能减退症（HR 2.07 [95% CI 1.07-4.44]，adjHR 1.77 [95% CI 0.91-3.46]）。在已确诊的乳糜泻患儿中，该比例为 3.4%（10/486）和 1.0%（5/481），HR 2.83 [95% CI 0.96-8.32]。在成年队列（n=1286）中，持续性阳性血清学组中有 4.5%（20/442）和正常血清学组中有 3.9%（33/811）发生甲状腺功能减退症（HR 1.13 [95% CI 0.65-1.97]）。
在本回顾性、年龄分层分析中，我们报告持续性阳性血清学可能与儿科人群中甲状腺功能减退症的风险相关。需要前瞻性队列研究来验证我们的发现。
