Association of Celiac Serology Normalization With the Risk of Hypothyroidism: A Cohort Study

Abstract

INTRODUCTION: We evaluated whether persistent-positive celiac serology is associated with the risk of hypothyroidism. METHODS:We extracted a cohort of subjects aged 1-80 years with a positive IgA anti-tissue transglutaminase between January 1, 2008, and December 31, 2012, and a repeat anti-tissue transglutaminase test within 6-36 months from a large population-based electronic medical record database. Based on serology tests, we categorized the pediatric (age <21 years) and adult cohorts into normalized or persistent-positive serology groups. All subjects were followed up for incident diagnosis of hypothyroidism from the last serology date up to December 31, 2017. Hazard ratio (HR) along 95% confidence intervals (CIs) were prepared to evaluate the association of celiac serology group with a diagnosis of hypothyroidism, crude, and adjusted for age, sex, and diagnosis of type 1 diabetes mellitus. RESULTS:Among the pediatric cohort (n 5 2,687), during a median follow-up of 64 months (interquartile range 48-80), 2.3% (16/681) of the persistent-positive serology group and 1.0% (20/2,006) of the normalized serology group developed hypothyroidism (HR 2.07 [95% CI 1.07-4.44], adjHR ). The rate among the pediatric cohort with an established diagnosis of celiac disease was 3.4% (10/486) vs 1.0% (5/481), HR 2.83 (0.96-8.32). In the adult cohort (n 5 1,286), 4.5% (20/442) of the persistent-positive group and 3.9% (33/811) of the normalized serology group developed hypothyroidism ).

Mendelian randomization analysis elucidates the causal relationship between celiac disease and the risk of thyroid dysfunction

“…[ 34 ] In a northern Sardinia case-control study, CeD patients had 26.0% hypothyroidism, compared to 12.9% for controls. [ 13 ] Children with continuously positive CeD serology showed a 2-fold higher incidence of the condition than those with normalized CeD serology, according to a cohort study by Golan et al [ 35 ] As part of a case study involving 335 CeD patients, it was discovered that their risk of producing thyroid dysfunction was higher than that of healthy individuals. [ 36 ] In a study of 14,021 patients, hypothyroidism, thyroiditis, and thyrotoxicosis all had strong correlations with CeD.…”