Risk of tuberculosis in a large sample of patients with coeliac disease - a nationwide cohort study
Risk of tuberculosis in a large sample of patients with coeliac disease - a nationwide cohort study
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DOI：
10.1111/j.1365-2036.2010.04572.x
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发表时间：
2011-03-15
影响因子：
7.6
通讯作者：
Wahlstrom, J.
中科院分区：
文献类型：
--
作者：
Ludvigsson, J. F.;Sanders, D. S.;Wahlstrom, J.
研究表明，乳糜泻与结核病之间存在正相关关系，但这项研究通常仅限于住院患者和小样本。方法我们收集了瑞典所有病理科室(n=28)的活检数据，以确定1969至2007年间被诊断为乳糜泻的个体(Marsh 3：绒毛萎缩；n=29 026个独特个体)。以人口为基础、性别和年龄匹配的对照是从总人口登记表中选择的。根据瑞典国家卫生登记处的数据，我们使用COX回归计算了结核病的风险比(HR)。结果在随访期间，31名乳糜泻患者和74名参考者被诊断为结核病。乳糜泻患者患结核病的绝对风险为10/10万人年，超额风险为5/10万人年。第一年的风险估计是最高的。将我们的结果限制在(I)结核病药物治疗记录(HR=2.9；95%CI=1.0-8.3)、(Ii)瑞典国家传染病监测系统中的数据(HR=2.6；95%CI=1.3-5.2)或(Iii)阳性结核病培养(HR=3.3；95%CI=1.6-6.8)会增加风险估计。在腹部疾病诊断之前，也观察到了腹部疾病与结核病的正相关(优势比=1.6；95%CI=1.2-2.1)。
P>BackgroundResearch suggests a positive association between coeliac disease and tuberculosis (TB), but that research has often been limited to in-patients and small sample size. We examined the relationship between TB and coeliac disease.AimTo examine the association of TB and coeliac disease.MethodsWe collected biopsy data from all pathology departments in Sweden (n = 28) to identify individuals who were diagnosed with coeliac disease between 1969 and 2007 (Marsh 3: villous atrophy; n = 29 026 unique individuals). Population-based sex- and age-matched controls were selected from the Total Population Register. Using Cox regression, we calculated hazard ratios (HRs) for TB from data in the Swedish national health registers.ResultsIndividuals with coeliac disease were at increased risk of TB (HR = 2.0; 95% CI = 1.3-3.0) (during follow-up, 31 individuals with coeliac disease and 74 reference individuals had a diagnosis of TB). The absolute risk of TB in patients with coeliac disease was 10/100 000 person-years with an excess risk of 5/100 000. Risk estimates were the highest in the first year. Restricting our outcome to a diagnosis of TB confirmed by (I) a record of TB medication (HR = 2.9; 95% CI = 1.0-8.3), (II) data in the National Surveillance System for Infectious Diseases in Sweden (HR = 2.6; 95% CI = 1.3-5.2) or (III) positive TB cultivation (HR = 3.3; 95% CI = 1.6-6.8) increased risk estimates. The positive association between coeliac disease and TB was also observed before the coeliac disease diagnosis (odds ratio = 1.6; 95% CI = 1.2-2.1).ConclusionWe found a moderately increased risk of tuberculosis in patients with coeliac disease.