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自身免疫性甲状腺疾病和微观结肠炎:瑞典全国匹配的病例控制研究
David Bergman1, Xiaoying Kang1,2, Jiangwei Sun1
1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
The Journal of clinical endocrinology and metabolism
|March 5, 2025
概括
患有自身免疫性甲状腺疾病 (AITDs) 的人患微观结肠炎 (MC) 的风险显著增加. 这种关联凸显了潜在的共享机制,以及需要对AITD患者的胃肠道症状保持警.
科学领域:
- 胃肠病学 胃肠病学
- 内分泌学 在内分泌学.
- 流行病学 流行病学
背景情况:
- 微观性结肠炎 (MC),包括质结肠炎 (CC) 和淋巴细胞性结肠炎 (LC),是一种导致水性腹的结肠炎症.
- 之前的研究表明,自身免疫性甲状腺疾病 (AITDs) 和MC之间存在联系,但大规模组织学研究是有限的.
研究的目的:
- 通过全国性,以人口为基础的方法,调查AITDs与发展MC的风险之间的关联.
- 通过兄弟分析,评估共同遗传和环境因素对AITD-MC协会的影响.
主要方法:
- 一项全国性,匹配的病例控制研究利用了ESPRESSO组织病理学队列中的活检确认的MC病例 (2006-2017年).
- 瑞典国家医疗保健登记处提供了关于AITD和共变量的数据.
- 条件后勤回归估计了与先前的AITDs相关的MC的概率比率 (ORs),并进行混对照的兄弟对照.
主要成果:
- 在10,301例MC病例 (12.0%) 中,AITD的患病率高于48,712例对照病例 (7.8%),调整后的OR为1.65 (95%CI:1.54-1.77).
- 在兄弟分析中,这种关联仍然显著 (OR:1.26;95% CI:1.11-1.43),表明存在强大的联系.
- 对于在50岁之前被诊断出MC的风险明显更高 (OR:2.41;95%CI:2.02-2.89),在CC和LC之间或性别之间没有发现显著差异.
结论:
- 患有AITD的个体面临患MC的风险较高,这表明共享的潜在病理生理机制.
- 这些发现强调了在AITD患者中监测胃肠道症状的重要性,并考虑对持续症状进行MC评估,即使在达到类甲状腺症后也是如此.
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