Borrelia infection and risk of celiac disease.
Borrelia infection and risk of celiac disease.
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DOI：
10.1186/s12916-017-0926-1
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发表时间：
2017-09-15
期刊：
影响因子：
9.3
通讯作者：
Ludvigsson JF
中科院分区：
文献类型：
--
作者：
Alaedini A;Lebwohl B;Wormser GP;Green PH;Ludvigsson JF
包括感染性因素在内的环境因素被认为在乳糜泻的发病率上升和地理分布方面发挥了作用。乳糜泻是一种自身免疫性疾病。在美国和瑞典，已经研究了乳糜泻发病率的区域差异，发现与莱姆病的地理分布相似，莱姆病是一种由伯氏疏螺旋体引起的新出现的多系统感染，因此增加了联系的可能性。我们的目标是确定感染疏螺旋体是否会增加乳糜泻的风险。瑞典所有病理部门的活检报告被用来识别15,769名乳糜泻患者。通过与全国患者登记表的链接，我们比较了乳糜泻患者和78,331名匹配的对照组中莱姆病的早期发生率。为了进一步评估疏螺旋体感染和乳糜泻之间的时间关系，我们还检查了被诊断为乳糜泻的患者继发莱姆病的风险。25名乳糜泻患者(0.16%)先前被诊断为莱姆病，而79名(0.5%)随后被诊断为莱姆病。莱姆病和乳糜泻之间存在适度的相关性，在乳糜泻诊断之前(优势比1.61；95%可信区间1.06-2.47)和诊断后(风险比1.82；95%可信区间1.40-2.35)，疾病风险在随访的第一年最高。只有一小部分乳糜泻患者之前被诊断为莱姆病。在乳糜泻诊断前后，莱姆病和乳糜泻之间的相似关联强烈地表明，监测偏向是可能的因素。综上所述，这些数据表明，疏螺旋体感染不是乳糜泻发生的实质性风险因素。
Environmental factors, including infectious agents, are speculated to play a role in the rising prevalence and the geographic distribution of celiac disease, an autoimmune disorder. In the USA and Sweden where the regional variation in the frequency of celiac disease has been studied, a similarity with the geographic distribution of Lyme disease, an emerging multisystemic infection caused by Borrelia burgdorferi spirochetes, has been found, thus raising the possibility of a link. We aimed to determine if infection with Borrelia contributes to an increased risk of celiac disease. Biopsy reports from all of Sweden’s pathology departments were used to identify 15,769 individuals with celiac disease. Through linkage to the nationwide Patient Register, we compared the rate of earlier occurrence of Lyme disease in the patients with celiac disease to that in 78,331 matched controls. To further assess the temporal relationship between Borrelia infection and celiac disease, we also examined the risk of subsequent Lyme disease in patients with a diagnosis of celiac disease. Twenty-five individuals (0.16%) with celiac disease had a prior diagnosis of Lyme disease, whereas 79 (0.5%) had a subsequent diagnosis of Lyme disease. A modest association between Lyme disease and celiac disease was seen both before (odds ratio, 1.61; 95% confidence interval (CI), 1.06–2.47) and after the diagnosis of celiac disease (hazard ratio, 1.82; 95% CI, 1.40–2.35), with the risk of disease being highest in the first year of follow-up. Only a minor fraction of the celiac disease patient population had a prior diagnosis of Lyme disease. The similar association between Lyme disease and celiac disease both before and after the diagnosis of celiac disease is strongly suggestive of surveillance bias as a likely contributor. Taken together, the data indicate that Borrelia infection is not a substantive risk factor in the development of celiac disease.
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影响因子：
9.8
作者：
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通讯作者：
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影响因子：
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