Younger Age at Onset and Sex Predict Celiac Disease in Children and Adolescents With Type 1 Diabetes

Abstract

OBJECTIVE -To estimate the prevalence of biopsy-confirmed celiac disease in Italian children and adolescents with type 1 diabetes and to assess whether age at onset of type 1 diabetes is independently associated with diagnosis of celiac disease.RESEARCH DESIGN AND METHODS -The study group was a clinic-based cohort of children and adolescents with type 1 diabetes cared for in 25 Italian centers for childhood diabetes. Yearly screening for celiac disease was performed using IgA/IgG anti-gliadin and IgA anti-endomysium antibodies.RESULTS -Of the 4,322 children and adolescents (age 11.8 Ϯ 4.2 years) identified with type 1 diabetes, biopsy-confirmed celiac disease was diagnosed in 292 (prevalence 6.8%, 95% confidence interval [CI] 6.0 -7.6), with a higher risk seen in girls than in boys (odds ratio [OR] 1.93, 1.51-2.47). In 89% of these, diabetes was diagnosed before celiac disease. In logistic regression analyses, being younger at onset of diabetes, being female, and having a diagnosis of a thyroid disorder were independently associated with the risk of having diabetes and celiac disease. In comparison with subjects who were older than 9 years at onset of diabetes, subjects who were younger than 4 years at onset had an OR of 3.27 (2.20 -4.85).CONCLUSIONS -We have provided evidence that 1) the prevalence of biopsy-confirmed celiac disease in children and adolescents with type 1 diabetes is high (6.8%); 2) the risk of having both diseases is threefold higher in children diagnosed with type 1 diabetes at age Ͻ4 years than in those age Ͼ9 years; and 3) girls have a higher risk of having both diseases than boys.

Type 1 diabetes and celiac disease: The effects of gluten free diet on metabolic control

“…In Italy, the prevalence of celiac disease in children with type 1 diabetes is around 7% [9,10] , 3.6% of which at type 1 diabetes onset [9] , at a younger age [10] and in boys [10] ; moreover, according to a study by Salardi et al [11] , the prevalence of celiac disease has significantly increased since 1994 (10.6% vs 6.6%, P = 0.015), probably due to changes in environmental factors, namely, eating habits and viral infections.…”

Enfermedad celiaca y diabetes mellitus tipo 1: asociación y características clínicas

“…La frecuencia de EC en pacientes con DM1 en nuestro estudio es un porcentaje alto (9,4%), en [4][5][6][7][8][9] comparación con otros estudios que varía entre 1 a 8%. Un estudio realizado en el Brasil encontró una 4 5 prevalencia del 2,5% , mientras que otro en España halló una prevalencia del 8% , existiendo series que 7 muestran prevalencia de hasta 12% .…”

Organ specific autoimmune disorders in type 1 diabetes mellitus

“…Development of CD can occur at any age but usually takes place within 5 years of diagnosis of T1DM. Cerutti et al 28 suggested that the highest risk of developing CD in children diagnosed with T1DM was under 4 years of age and the risk was much lower in children of school going age and older children. An epidemiological study from Australia reported that CD is common in young patients with young age of onset of diabetes (< 5years of age) and longer duration of diabetes mellitus.…”