Dore Maria Pina, Fanciulli Giuseppe, Rouatbi Malik, Mereu Sandro, Pes Giovanni Mario
Dipartimento di Medicina, Chirurgia e Farmacia, Clinica Medica, University of Sassari, Viale San Pietro 8, 07100 Sassari, Italy.
Baylor College of Medicine, One Baylor Plaza Blvd. Houston, Houston, TX 77030, USA.
J Clin Med. 2022 Oct 12;11(20):6027. doi: 10.3390/jcm11206027.
Background. Among patients with celiac disease (CD), there is an increased incidence of autoimmune thyroid disorders (AITDs), with hypothyroidism being more frequent than hyperthyroidism. This retrospective case-control study aimed to explore the prevalence of TDs in a population of adult celiac patients from Northern Sardinia, a geographic area with a high prevalence of autoimmune disorders. Methods. Data were collected from consecutive patients with CD (cases) and without CD (controls) who were undergoing upper endoscopy and referred to a tertiary gastroenterology section of a teaching hospital (University of Sassari, Italy). Thyroid disorders were stratified as (i) autoimmune: including Hashimoto’s disease in euthyroidism or with hypofunction, and Graves’ disease; or (ii) non-autoimmune: thyroid nodules/goiter, iatrogenic thyroid hypo/hyperfunction, and thyroidectomy for any reason, including cancer. Results. Among a total of 8489 participants (females 5839, 64.7%) enrolled, there were 623 (7.3%) celiac patients and 7866 controls (92.7%). The overall frequency of TDs was 1177 (13.9%) and was higher (26.0%) in celiac patients than in controls (12.9%) (p < 0.001). The difference between AITDs (15.4% vs. 7.5%) and no-AITDs (2.7% vs. 1.1%) was statistically significant in CD patients compared with controls, respectively, and prevailed in the fifth and sixth decades. Hashimoto’s thyroiditis was more commonly associated with gland hypofunction. Odds ratios with their 95% confidence intervals (CIs) for the presence of AITDs were calculated, adjusting for sex, age, body mass index, smoking habits, occupation, and residence, and they were 2.387 (95% CI 1.857−3.068, p < 0.001) in CD patients, 5.855 (95% CI 4.434−7.731, p < 0.001) for female sex, and 1.012 (95% CI, 1.007−1.017, p < 0.001) for age. Conclusion. These results suggest the need for surveillance for TDs in patients with CD at onset and during follow-up.
背景。在乳糜泻（CD）患者中，自身免疫性甲状腺疾病（AITD）的发病率增加，其中甲状腺功能减退比甲状腺功能亢进更常见。这项回顾性病例对照研究旨在探讨撒丁岛北部成年乳糜泻患者中甲状腺疾病（TD）的患病率，该地区是自身免疫性疾病高发地区。方法。数据收集自连续接受上消化道内镜检查并转诊至一家教学医院（意大利萨萨里大学）三级胃肠病科的CD患者（病例组）和非CD患者（对照组）。甲状腺疾病分为：（i）自身免疫性：包括甲状腺功能正常或减退的桥本氏病以及格雷夫斯病；或（ii）非自身免疫性：甲状腺结节/甲状腺肿、医源性甲状腺功能减退/亢进以及因任何原因（包括癌症）进行的甲状腺切除术。结果。在总共纳入的8489名参与者（女性5839名，占64.7%）中，有623名（7.3%）乳糜泻患者和7866名对照组（92.7%）。TD的总体发生率为1177例（13.9%），乳糜泻患者中的发生率（26.0%）高于对照组（12.9%）（p<0.001）。与对照组相比，CD患者中AITD（15.4%对7.5%）和非AITD（2.7%对1.1%）之间的差异具有统计学意义，且在五、六十岁人群中更为普遍。桥本氏甲状腺炎更常与腺体功能减退相关。计算了存在AITD的比值比及其95%置信区间（CI），并对性别、年龄、体重指数、吸烟习惯、职业和居住情况进行了校正，CD患者中为2.387（95%CI 1.857 - 3.068，p<0.001），女性为5.855（95%CI 4.434 - 7.731，p<0.001），年龄为1.012（95%CI 1.007 - 1.017，p<0.001）。结论。这些结果表明，需要在CD患者发病时及随访期间对TD进行监测。
