The Journal of clinical endocrinology and metabolism · 2012
Primary hyperparathyroidism and celiac disease: a population-based cohort study.
СтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Ludvigsson Jonas F, Kämpe Olle, Lebwohl Benjamin, Green Peter H R, Silverberg Shonni J, Ekbom Anders
Аннотация
CONTEXT: Celiac disease (CD) has been linked to several endocrine disorders, including type 1 diabetes and thyroid disorders, but little is known regarding its association to primary hyperparathyroidism (PHPT).
OBJECTIVE: The aim of the study was to examine the risk of PHPT in patients with CD.
DESIGN AND SETTING: We conducted a two-group exposure-matched nonconcurrent cohort study in Sweden. A Cox regression model estimated hazard ratios (HR) for PHPT.
PARTICIPANTS: We identified 17,121 adult patients with CD who were diagnosed through biopsy reports (Marsh 3, villous atrophy) from all 28 pathology departments in Sweden. Biopsies were performed in 1969-2008, and biopsy report data were collected in 2006-2008. Statistics Sweden then identified 85,166 reference individuals matched with the CD patients for age, sex, calendar period, and county.
MAIN OUTCOME MEASURE: PHPT was measured according to the Swedish national registers on inpatient care, outpatient care, day surgery, and cancer.
RESULTS: During follow-up, 68 patients with CD and 172 reference individuals developed PHPT (HR=1.91; 95% confidence interval=1.44-2.52). The absolute risk of PHPT was 42/100,000 person-years with an excess risk of 20/100,000 person-years. The risk increase for PHPT only occurred in the first 5 yr of follow-up; after that, HR were close to 1 (HR=1.07; 95% confidence interval=0.70-1.66).
CONCLUSIONS: CD patients are at increased risk of PHPT, but the absolute risk is small, and the excess risk disappeared after more than 5 yr of follow-up.
OBJECTIVE: The aim of the study was to examine the risk of PHPT in patients with CD.
DESIGN AND SETTING: We conducted a two-group exposure-matched nonconcurrent cohort study in Sweden. A Cox regression model estimated hazard ratios (HR) for PHPT.
PARTICIPANTS: We identified 17,121 adult patients with CD who were diagnosed through biopsy reports (Marsh 3, villous atrophy) from all 28 pathology departments in Sweden. Biopsies were performed in 1969-2008, and biopsy report data were collected in 2006-2008. Statistics Sweden then identified 85,166 reference individuals matched with the CD patients for age, sex, calendar period, and county.
MAIN OUTCOME MEASURE: PHPT was measured according to the Swedish national registers on inpatient care, outpatient care, day surgery, and cancer.
RESULTS: During follow-up, 68 patients with CD and 172 reference individuals developed PHPT (HR=1.91; 95% confidence interval=1.44-2.52). The absolute risk of PHPT was 42/100,000 person-years with an excess risk of 20/100,000 person-years. The risk increase for PHPT only occurred in the first 5 yr of follow-up; after that, HR were close to 1 (HR=1.07; 95% confidence interval=0.70-1.66).
CONCLUSIONS: CD patients are at increased risk of PHPT, but the absolute risk is small, and the excess risk disappeared after more than 5 yr of follow-up.