title: Turner Syndrome and Celiac Disease: A Case-Control Study.
abstract: OBJECTIVE
  Turner syndrome (TS) is the most common sex chromosome abnormality in females. Previous research has indicated a high prevalence of celiac disease (CD) in TS, but data have mostly been limited to case series at tertiary centers. We aimed to examine the risk for CD in individuals with TS compared with the general population.
  
  
  METHODS
  This Swedish nationwide case-control study included individuals with CD and controls born in 1973-2006. The study consisted of 2 groups: (1) 7548 females with biopsy-verified CD (villous atrophy; Marsh stage 3) diagnosed until January 2008 according to histopathology report data from all 28 Swedish pathology departments and (2) 34 492 population-based controls matched by gender, age, calendar year of birth, and county of residence. TS, diagnosed by the end of 2009, was identified using prospectively recorded data from 3 nationwide health registries. Odds ratios (ORs) for CD were calculated using conditional logistic regression.
  
  
  RESULTS
  Of the 7548 females with CD, 20 had a diagnosis of TS (0.26%) compared with 21 of 34 492 controls (0.06%), corresponding to an OR of 3.29 (95% confidence interval [CI] 1.94-5.56) for CD in individuals with TS. The risk of CD in females with TS ranged from twofold (OR 2.16; 95% CI 0.91-5.11) in the first 5 years of life to a more than fivefold increase in females aged >10 years at CD diagnosis (OR 5.50; 95% CI 1.53-19.78). The association between TS and CD was largely unaffected by concurrent type 1 diabetes.
  
  
  CONCLUSIONS
  Females with TS are more likely to develop CD. This study supports active case-finding for CD in TS.
authors.affiliation: Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; karlmarild@gmail.com.
authors.forename: Karl
authors.initials: K
authors.lastname: Mårild
authors.affiliation: Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway; Department of Pediatrics, Østfold Hospital Trust, Fredrikstad, Norway;
authors.forename: Ketil
authors.initials: K
authors.lastname: Størdal
authors.affiliation: Department of Obstetrics and Gynecology, Norra Älvsborg Hospital, Trollhättan, Sweden; and.
authors.forename: Anna
authors.initials: A
authors.lastname: Hagman
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.
authors.forename: Jonas F
authors.initials: JF
authors.lastname: Ludvigsson
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002446:Celiac Disease / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D016017:Odds Ratio; D012042:Registries; D012307:Risk Factors; D013548:Sweden; D014424:Turner Syndrome / Q000150:complications*