== Euthyroidism autoimmune thyroid disease: EATD The Newcastle-Ottawa Level guidelines are widely used to evaluate case-control and cohort studies for quality. 79342 settings. Overall, the prevalence of thyroid disease in individuals with CD was significantly increased in contrast to that in the control organizations (OR several. 08, 95% CI 2 . 673. 56, P <0. 001). Moreover, there was no significant difference in the OR between gluten-treated and untreated organizations (OR 1 . 08, 95% CI 0. 611. 92, P= 0. 786). The results of our meta-analysis support the hypothesis that the prevalence of thyroid disease in patients with CD is usually increased in contrast to that in controls, which suggests that CD patients must be screened pertaining to thyroid disease. The effect of gluten-free treatment on thyroid disease needs further exploration. == Launch == Celiac disease (CD) is an autoimmune disorder disease characterized by chronic inflammation and villous atrophy in the small intestine[1]. This disease is usually caused by the ingestion of gluten-containing foods and other environmental factors. As originally described in the 19th century, CD is characterized by steatorrhoea, vomiting, and cachexia in early childhood. F2rl1 The common clinical manifestations of CD include diarrhoea, emaciation, aphthous stomatitis, and malabsorption, and many patients exhibit only mild or no symptoms at all[2, 3]. The working group of the European Society of Paediatric Gastroenterology and Nutrition recommend the use of serological tests as diagnostic criteria for CD. However , the gold diagnostic standard for CD is still the histological changes in the small bowel mucosa. A life-long gluten-free diet is an effective (-)-Securinine and common method to treat CD[4]. CD has a prevalence of approximately (-)-Securinine 1% among Western nations[5, 6]. The associations of CD with ulcerative colitis, Crohns disease, microscopic colitis, autoimmune liver diseases, and several other immune- and non-immune-based diseases in the digestive system are well recognized. However , many diseases outside the digestive system, such as autoimmune thyroid disease, Sjgrens syndrome, type 1 diabetes mellitus, and Addisons disease, are associated with CD, in both its overt and silent forms[7]. For example , a meta-analysis based on 26605 patients with type 1 diabetes mellitus revealed a 6. 0% prevalence of biopsy-confirmed CD, which was increased compared with the prevalence among healthy controls[8]. Thyroid disease may be related to CD as well. The prevalence of thyroid disease among CD patients was 10. 8% in Sweden[9]. Similarly, Hadithiet al. found that of 184 patients with CD, 39 (21%) were positive for thyroid antibodies in a Dutch population[10]. Saleemet al. also investigated 106 patients with CD in Ireland between 1988 and 2004. The prevalence of thyroid disease was 7%, which was higher than that of other diseases (rheumatoid disease 3%, inflammatory bowel disease 4%, and type 1 diabetes mellitus 2%)[11]. Several studies failed to identify a significant relationship between CD and thyroid disease[12, 13]. However , most of these studies were cross-sectional (-)-Securinine surveys and lacked controls. In addition , exposure to gluten-free treatment may be associated with a risk of thyroid disease[14, 15], but this association remains uncertain. The prevalence of thyroid disease is likely increased among individuals with CD. However , this relationship remains controversial. The purpose of this study was to evaluate the risk of thyroid disease in patients with CD. A secondary objective was to study the effect of gluten-free treatment on thyroid disease. == Methods == A completed PRISMA checklist is presented inS1 File. == Search == A systematic literature search without language restriction was performed independently by two researchers (Y. W. and L. S. ) using the PubMed, Web of Science, Embase, and Chinese WanFang bibliographical databases with the words celiac disease or coeliac disease in combination with the terms thyroid disease, or thyroiditis, or thyroid antibody, or hypothyroidism, or hyperthyroidism in the title or abstract. The literature was searched for the period up to May 2016. In addition , the reference lists of the retrieved articles were examined to identify additional eligible studies. == Inclusion criteria == Eligible studies included in this meta-analysis met all the following criteria: (1) all the CD patients were newly diagnosed or untreated with gluten; (2) a case-control or cohort design was used; (3) sufficient data on cases and controls were provided to enable calculation of the odds ratio (OR) with 95% confidence interval (CI) andP-value. Reviews, case reports, and letters were excluded from this meta-analysis. == Data extraction == The following information was extracted from the included studies by two reviewers independently (L. L., Y. B. L. ): first author, publication (-)-Securinine year, region, population, numbers of cases and controls, and details regarding thyroid disease in the cases and controls. Disagreements were resolved by discussion between two reviewers. If a consensus could not be reached, another reviewer settled the disagreement. The patients in the studies were classified into four groups for further meta-analysis: (1) thyroid disease group, (2) euthyroidism autoimmune thyroid disease group, (3) hypothyroidism group, and (4) hyperthyroidism group. The thyroid disease group was defined as.