Norelle R Reilly1, Benjamin Lebwohl2, Kaziwe Mollazadegan3, Karl Michaëlsson4, Peter H R Green5, Jonas F Ludvigsson6. 1. Division of Pediatric Gastroenterology, Columbia University Medical Center, New York, NY; Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, NY. 2. Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, NY; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 3. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 4. Department of Surgical Sciences, Uppsala University, Uppsala, Sweden. 5. Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, NY. 6. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro University, Örebro, Sweden. Electronic address: jonasludvigsson@yahoo.com.
Abstract
OBJECTIVES: To examine the risk of any fractures in patients with both type 1 diabetes (T1D) and celiac disease (CD) vs patients with T1D only. STUDY DESIGN: We performed a population-based cohort study. We defined T1D as individuals aged ≤30 years who had a diagnosis of diabetes recorded in the Swedish National Patient Register between 1964 and 2009. Individuals with CD were identified through biopsy report data between 1969 and 2008 from any of Sweden's 28 pathology departments. Some 958 individuals had both T1D and CD and were matched for sex, age, and calendar period with 4598 reference individuals with T1D only. We then used a stratified Cox regression analysis, where CD was modeled as a time-dependent covariate, to estimate the risk of any fractures and osteoporotic fractures (hip, distal forearm, thoracic and lumbar spine, and proximal humerus) in patients with both T1D and CD compared with that in patients with T1D only. RESULTS: During follow-up, 12 patients with T1D and CD had a fracture (1 osteoporotic fracture). CD did not influence the risk of any fracture (adjusted hazard ratio = 0.77; 95% CI = 0.42-1.41) or osteoporotic fractures (adjusted hazard ratio = 0.46; 95% CI = 0.06-3.51) in patients with T1D. Stratification for time since CD diagnosis did not affect risk estimates. CONCLUSION: Having a diagnosis of CD does not seem to influence fracture risk in young patients with T1D. Follow-up in this study was, however, too short to ascertain osteoporotic fractures which traditionally occur in old age.
OBJECTIVES: To examine the risk of any fractures in patients with both type 1 diabetes (T1D) and celiac disease (CD) vs patients with T1D only. STUDY DESIGN: We performed a population-based cohort study. We defined T1D as individuals aged ≤30 years who had a diagnosis of diabetes recorded in the Swedish National Patient Register between 1964 and 2009. Individuals with CD were identified through biopsy report data between 1969 and 2008 from any of Sweden's 28 pathology departments. Some 958 individuals had both T1D and CD and were matched for sex, age, and calendar period with 4598 reference individuals with T1D only. We then used a stratified Cox regression analysis, where CD was modeled as a time-dependent covariate, to estimate the risk of any fractures and osteoporotic fractures (hip, distal forearm, thoracic and lumbar spine, and proximal humerus) in patients with both T1D and CD compared with that in patients with T1D only. RESULTS: During follow-up, 12 patients with T1D and CD had a fracture (1 osteoporotic fracture). CD did not influence the risk of any fracture (adjusted hazard ratio = 0.77; 95% CI = 0.42-1.41) or osteoporotic fractures (adjusted hazard ratio = 0.46; 95% CI = 0.06-3.51) in patients with T1D. Stratification for time since CD diagnosis did not affect risk estimates. CONCLUSION: Having a diagnosis of CD does not seem to influence fracture risk in young patients with T1D. Follow-up in this study was, however, too short to ascertain osteoporotic fractures which traditionally occur in old age.
Authors: Jonas F Ludvigsson; Daniel A Leffler; Julio C Bai; Federico Biagi; Alessio Fasano; Peter H R Green; Marios Hadjivassiliou; Katri Kaukinen; Ciaran P Kelly; Jonathan N Leonard; Knut Erik Aslaksen Lundin; Joseph A Murray; David S Sanders; Marjorie M Walker; Fabiana Zingone; Carolina Ciacci Journal: Gut Date: 2012-02-16 Impact factor: 23.059
Authors: Katriina Heikkilä; Markku Heliövaara; Olli Impivaara; Heikki Kröger; Paul Knekt; Harri Rissanen; Markku Mäki; Katri Kaukinen Journal: J Bone Miner Res Date: 2015-04 Impact factor: 6.741
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