Primary hyperparathyroidism and celiac disease: a population-based cohort study

J Clin Endocrinol Metab. 2012 Mar;97(3):897-904. doi: 10.1210/jc.2011-2639. Epub 2012 Jan 11.


Context: Celiac disease (CD) has been linked to several endocrine disorders, including type 1 diabetes and thyroid disorders, but little is known regarding its association to primary hyperparathyroidism (PHPT).

Objective: The aim of the study was to examine the risk of PHPT in patients with CD.

Design and setting: We conducted a two-group exposure-matched nonconcurrent cohort study in Sweden. A Cox regression model estimated hazard ratios (HR) for PHPT.

Participants: We identified 17,121 adult patients with CD who were diagnosed through biopsy reports (Marsh 3, villous atrophy) from all 28 pathology departments in Sweden. Biopsies were performed in 1969-2008, and biopsy report data were collected in 2006-2008. Statistics Sweden then identified 85,166 reference individuals matched with the CD patients for age, sex, calendar period, and county.

Main outcome measure: PHPT was measured according to the Swedish national registers on inpatient care, outpatient care, day surgery, and cancer.

Results: During follow-up, 68 patients with CD and 172 reference individuals developed PHPT (HR=1.91; 95% confidence interval=1.44-2.52). The absolute risk of PHPT was 42/100,000 person-years with an excess risk of 20/100,000 person-years. The risk increase for PHPT only occurred in the first 5 yr of follow-up; after that, HR were close to 1 (HR=1.07; 95% confidence interval=0.70-1.66).

Conclusions: CD patients are at increased risk of PHPT, but the absolute risk is small, and the excess risk disappeared after more than 5 yr of follow-up.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Celiac Disease / diagnosis
  • Celiac Disease / epidemiology*
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperparathyroidism, Primary / epidemiology*
  • Incidence
  • Male
  • Middle Aged
  • Registries
  • Risk
  • Risk Factors
  • Sweden