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Review
. 2016 Dec 28;11(12):e0168708.
doi: 10.1371/journal.pone.0168708. eCollection 2016.

Increased Incidence of Thyroid Disease in Patients With Celiac Disease: A Systematic Review and Meta-Analysis

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Free PMC article
Review

Increased Incidence of Thyroid Disease in Patients With Celiac Disease: A Systematic Review and Meta-Analysis

Xin Sun et al. PLoS One. .
Free PMC article

Abstract

The prevalence of thyroid disease is likely increased among individuals with celiac disease (CD). In addition, exposure to gluten-free treatment may be associated with a risk of thyroid disease, but this association remains controversial. A systematic review was performed to evaluate the association between thyroid disease and CD. The articles were obtained from the PubMed, Web of Science, Embase, and Chinese WanFang bibliographical databases for the period up to May 2016. The results were analysed in a meta-analysis with odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs). There were 13 articles in this meta-analysis, including 15629 CD cases and 79342 controls. Overall, the prevalence of thyroid disease in patients with CD was significantly increased compared with that in the control groups (OR 3.08, 95% CI 2.67-3.56, P<0.001). Moreover, there was no significant difference in the OR between the gluten-treated and untreated groups (OR 1.08, 95% CI 0.61-1.92, P = 0.786). The results of our meta-analysis support the hypothesis that the prevalence of thyroid disease in patients with CD is increased compared with that in controls, which suggests that CD patients should be screened for thyroid disease. The effect of gluten-free treatment on thyroid disease needs further investigation.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow charts showing the detailed procedure for the inclusion or exclusion of studies.
Thirteen independent studies were included in this meta-analysis.
Fig 2
Fig 2. Forest plots for the frequency of thyroid disease in patients with celiac disease compared to that in controls.
The diamond represents the pooled OR and 95% CI.
Fig 3
Fig 3. Forest plots for the frequency of euthyroidism autoimmune thyroid disease in patients with celiac disease compared to that in controls.
The diamond represents the pooled OR and 95% CI.
Fig 4
Fig 4. Forest plots for the frequency of hypothyroidism in patients with celiac disease compared to that in controls.
The diamond represents the pooled OR and 95% CI.
Fig 5
Fig 5. Forest plots for the frequency of hyperthyroidism in patients with celiac disease compared to that in controls.
The diamond represents the pooled OR and 95% CI.
Fig 6
Fig 6. Forest plots for the frequency of thyroid disease in gluten-free-treated patients with celiac disease compared to that in untreated patients.
The diamond represents the pooled OR and 95% CI.
Fig 7
Fig 7. Funnel plot for testing the publication bias of the association between celiac disease and the risk of thyroid disease.
Each point represents an individual study on the indicated association. The vertical line indicates the effect size.

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Grant support

The authors received no specific funding for this work.
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