Abstract：
BACKGROUND: Predominantly antibody deficiency (PAD) is associated with noninfectious inflammatory gastrointestinal disease. Population estimates of celiac disease (CeD) risk in those with PAD are limited.
OBJECTIVE: To estimate population risk of PAD in individuals with CeD.
METHODS: We conducted a nationwide case-control study in Swedish individuals who received a diagnosis of CeD between 1997 and 2017 (n = 34,980), matched to population comparators by age, sex, calendar year, and county. The CeD was confirmed through the Epidemiology Strengthened by histopathology Reports in Sweden study, which provided information on biopsy specimens from each of Sweden\'s pathology departments. PAD was identified using International Classification of Diseases, 10th Revision coding and categorized according to the International Union of Immunologic Societies. Logistic regression was used to calculate adjusted odds ratios (aORs) and 95% CIs.
RESULTS: PAD was more prevalent in CeD than in population controls (n = 105 [0.3%] vs n = 57 [0.033%], respectively). This translated to an aOR of 8.23 (95% CI 5.95-11.48). The association was strongest with common variable immunodeficiency (aOR 17.25; 95% CI 6.86-52.40), and slightly lower in other PAD (aOR 8.39; 95% CI 5.79-12.32). The risk of CeD remained increased at least 5 years after diagnosis of PAD (aOR 4.79; 95% CI 2.89-7.97, P-heterogeneity ≤ 0.001).
CONCLUSIONS: PAD was associated with an increased risk of CeD. A particularly strong association was seen in those with CVID, although this should be interpreted cautiously given the limited understanding of the mechanisms of histopathologic changes in these patients.
OBJECTIVE: To estimate population risk of PAD in individuals with CeD.
METHODS: We conducted a nationwide case-control study in Swedish individuals who received a diagnosis of CeD between 1997 and 2017 (n = 34,980), matched to population comparators by age, sex, calendar year, and county. The CeD was confirmed through the Epidemiology Strengthened by histopathology Reports in Sweden study, which provided information on biopsy specimens from each of Sweden\'s pathology departments. PAD was identified using International Classification of Diseases, 10th Revision coding and categorized according to the International Union of Immunologic Societies. Logistic regression was used to calculate adjusted odds ratios (aORs) and 95% CIs.
RESULTS: PAD was more prevalent in CeD than in population controls (n = 105 [0.3%] vs n = 57 [0.033%], respectively). This translated to an aOR of 8.23 (95% CI 5.95-11.48). The association was strongest with common variable immunodeficiency (aOR 17.25; 95% CI 6.86-52.40), and slightly lower in other PAD (aOR 8.39; 95% CI 5.79-12.32). The risk of CeD remained increased at least 5 years after diagnosis of PAD (aOR 4.79; 95% CI 2.89-7.97, P-heterogeneity ≤ 0.001).
CONCLUSIONS: PAD was associated with an increased risk of CeD. A particularly strong association was seen in those with CVID, although this should be interpreted cautiously given the limited understanding of the mechanisms of histopathologic changes in these patients.
摘要：
背景：主要抗体缺乏（PAD）与非感染性炎症性胃肠道（GI）疾病有关。人群对PAD患者乳糜泻（CeD）风险的估计是有限的。
目的：估计CeD患者的PAD风险。
方法：我们对在1997年至2017年之间接受CeD诊断的瑞典人进行了一项全国性的病例对照研究（n=34,980）。按年龄与人口比较者相匹配，性别,日历年,县。通过瑞典组织病理学报告加强的流行病学（ESPRESSO）研究证实了CeD，提供了瑞典每个病理科的活检标本信息。PAD使用国际疾病分类(ICD)第10次修订编码进行鉴定,并根据国际免疫学会联合会(IUIS)进行分类。Logistic回归用于计算调整后的比值比（aOR）和95％置信区间（CI）。
结果：与人群对照组相比，CeD中的PAD更为普遍（n=105（0.3％）vsn=57（0.033％），分别)。这转换为8.23的aOR(95CI5.95-11.48)。与普通可变免疫缺陷（CVID）的相关性最强（aOR17.25;95CI6.86-52.40），其他PAD略低（aOR8.39；95CI5.79-12.32）。在诊断PAD后≥5年，CeD的风险仍然增加（aOR4.79;95CI2.89-7.97，p异质性<0.001）。
结论：PAD与CeD风险增加相关。在那些有CVID的人中看到了特别强的关联，尽管对这些患者的组织病理学改变的机制了解有限，但应该谨慎解释。
目的：估计CeD患者的PAD风险。
方法：我们对在1997年至2017年之间接受CeD诊断的瑞典人进行了一项全国性的病例对照研究（n=34,980）。按年龄与人口比较者相匹配，性别,日历年,县。通过瑞典组织病理学报告加强的流行病学（ESPRESSO）研究证实了CeD，提供了瑞典每个病理科的活检标本信息。PAD使用国际疾病分类(ICD)第10次修订编码进行鉴定,并根据国际免疫学会联合会(IUIS)进行分类。Logistic回归用于计算调整后的比值比（aOR）和95％置信区间（CI）。
结果：与人群对照组相比，CeD中的PAD更为普遍（n=105（0.3％）vsn=57（0.033％），分别)。这转换为8.23的aOR(95CI5.95-11.48)。与普通可变免疫缺陷（CVID）的相关性最强（aOR17.25;95CI6.86-52.40），其他PAD略低（aOR8.39；95CI5.79-12.32）。在诊断PAD后≥5年，CeD的风险仍然增加（aOR4.79;95CI2.89-7.97，p异质性<0.001）。
结论：PAD与CeD风险增加相关。在那些有CVID的人中看到了特别强的关联，尽管对这些患者的组织病理学改变的机制了解有限，但应该谨慎解释。
