Autoimmune Thyroid Disorders Are More Prevalent in Patients with Celiac Disease: A Retrospective Case-Control Study

Abstract

Background. Among patients with celiac disease (CD), there is an increased incidence of autoimmune thyroid disorders (AITDs), with hypothyroidism being more frequent than hyperthyroidism. This retrospective case-control study aimed to explore the prevalence of TDs in a population of adult celiac patients from Northern Sardinia, a geographic area with a high prevalence of autoimmune disorders. Methods. Data were collected from consecutive patients with CD (cases) and without CD (controls) who were undergoing upper endoscopy and referred to a tertiary gastroenterology section of a teaching hospital (University of Sassari, Italy). Thyroid disorders were stratified as (i) autoimmune: including Hashimoto’s disease in euthyroidism or with hypofunction, and Graves’ disease; or (ii) non-autoimmune: thyroid nodules/goiter, iatrogenic thyroid hypo/hyperfunction, and thyroidectomy for any reason, including cancer. Results. Among a total of 8489 participants (females 5839, 64.7%) enrolled, there were 623 (7.3%) celiac patients and 7866 controls (92.7%). The overall frequency of TDs was 1177 (13.9%) and was higher (26.0%) in celiac patients than in controls (12.9%) (p < 0.001). The difference between AITDs (15.4% vs. 7.5%) and no-AITDs (2.7% vs. 1.1%) was statistically significant in CD patients compared with controls, respectively, and prevailed in the fifth and sixth decades. Hashimoto’s thyroiditis was more commonly associated with gland hypofunction. Odds ratios with their 95% confidence intervals (CIs) for the presence of AITDs were calculated, adjusting for sex, age, body mass index, smoking habits, occupation, and residence, and they were 2.387 (95% CI 1.857‒3.068, p < 0.001) in CD patients, 5.855 (95% CI 4.434‒7.731, p < 0.001) for female sex, and 1.012 (95% CI, 1.007‒1.017, p < 0.001) for age. Conclusion. These results suggest the need for surveillance for TDs in patients with CD at onset and during follow-up.

Celiac Disease and Cardiovascular Risk: A Retrospective Case-Control Study

“…Similarly, current and former smokers were more represented among cases than among controls. Interestingly, the frequency of CD patients was only 2.2% among those with a diagnosis of CVD, while it was 9.5% among controls, i.e., a value consistent with previous results observed in the same population [ 8 ]. The prevalence of dyslipidemia was threefold higher in patients with CVD compared with patients without CVD (20.1% vs. 6.8%) ( Table 1 ).…”

“…It is widely known that CD can be associated with multiple organ involvement, which justifies its classification as a systemic disorder [ 5 ]. Aside from its association with other autoimmune diseases such as type 1 diabetes, Hashimoto’s thyroiditis, and primary sclerosing cholangitis [ 8 , 14 , 43 ], usually explained by the sharing of various immune mechanisms [ 44 ], the potential association between CD and CVD has gained a lot of interest during the past decade, and the literature is currently recording an exponential growth of publications on this specific field. Most studies in this area, whether observational studies [ 45 ], prospective studies [ 20 , 46 ], or meta-analyses [ 23 , 24 , 25 ] have reported an increased atherogenic cardiovascular risk in CD patients, especially related to coronary or peripheral districts.…”

“…This reappraisal of CD as a systemic disorder has resulted in an emerging interest in the extraintestinal manifestations of the disease [ 6 ]. This prompted researchers to pose the question of whether, in the long run, the CD could actually constitute a risk factor for disorders involving other organs besides the gut, such as the nervous system [ 7 ], the endocrine system [ 8 ], the cardiovascular system [ 9 , 10 ], the reproductive system [ 11 ], the skin [ 12 ] and the immune system [ 13 , 14 ].…”

The Influence of Nutritional Intervention in the Treatment of Hashimoto’s Thyroiditis—A Systematic Review

“…The elimination of gluten from a diet is a treatment for diseases such as celiac disease, Duhring’s disease, wheat allergy, or non-celiac gluten sensitivity (NCGS) [ 43 ]. Among patients with Hashimoto’s disease, celiac disease is more prevalent [ 44 ]. This may result in a higher levothyroxine requirement owing to the lower absorption capacity of LT4 in the gastrointestinal tract [ 45 ].…”

The Role of Toll-like Receptor 2 (TLR2) in the Development and Progression of Hashimoto’s Disease (HD): A Case Study on Female Patients in Poland

“…Studies show that the frequency of developing this disease increases with the age of patients (especially after 60 years of age); however, more and more often, this entity is also diagnosed in young people and even children [ 6 , 7 , 8 , 9 ]. The causes of hypothyroidism and thus the development of HD are many, ranging from genetic factors and hormonal changes to environmental factors, as well as the presence of other comorbidities, especially those of autoimmune origin [ 10 , 11 , 12 , 13 ]. HD itself is classified as a subunit of autoimmune diseases, which means that its development is closely related to the deregulation of the immune system, and, more specifically, to the development of inflammation caused by the host’s immune cells (in particular T lymphocyte-induced apoptosis of thyroid follicular cells) that attack the thyroid [ 14 , 15 , 16 ].…”