Cristina Canova1, Gisella Pitter2, Jonas F Ludvigsson3, Pierantonio Romor4, Loris Zanier5, Renzo Zanotti2, Lorenzo Simonato2. 1. Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padua, Padua, Italy. Electronic address: cristina.canova@unipd.it. 2. Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padua, Padua, Italy. 3. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden. 4. Friuli-Venezia Giulia Regional Health Information System, Informatica per il Sistema degli Enti Locali (INSIEL) S.p.A., Udine, Italy. 5. Epidemiological Service, Health Directorate, Friuli Venezia-Giulia Region, Udine, Italy.
Abstract
OBJECTIVES: To estimate the relative risk of developing type 1 diabetes mellitus (T1DM) and autoimmune thyroid disease in children with celiac disease (CD). STUDY DESIGN: A matched cohort design with linkage of administrative data was adopted. A total of 1215 cases of CD and 6075 references matched by sex and year of birth born in Friuli Venezia Giulia Region (Italy) between 1989 and 2011 were included. Cox regression models were used to estimate hazard ratios (HRs) for autoimmune diseases in patients with CD compared with references, stratified by sex and age at diagnosis. RESULTS: Individuals with CD had an increased risk of subsequent hypothyroidism (HR 4.64 [95% CI 2.88-7.46]) and T1DM (HR 2.50 [95% CI 0.94-6.66]), the latter not statistically significant. Risk of hypothyroidism was higher in males (HR 20.00; 95% CI 5.64-70.87) than females (HR 3.21; 95% CI 1.85-5.57) (P value <.01). No differences were observed between males and females risks for diabetes or age at CD diagnosis. The small number of hyperthyroidism cases identified precluded any statistical analysis. CONCLUSIONS: Children and youth with CD are at increased risk of developing autoimmune hypothyroidism and to some extent T1DM. This suggests the need for surveillance of children with CD in order to timely detect the onset of such comorbidities.
OBJECTIVES: To estimate the relative risk of developing type 1 diabetes mellitus (T1DM) and autoimmune thyroid disease in children with celiac disease (CD). STUDY DESIGN: A matched cohort design with linkage of administrative data was adopted. A total of 1215 cases of CD and 6075 references matched by sex and year of birth born in Friuli Venezia Giulia Region (Italy) between 1989 and 2011 were included. Cox regression models were used to estimate hazard ratios (HRs) for autoimmune diseases in patients with CD compared with references, stratified by sex and age at diagnosis. RESULTS: Individuals with CD had an increased risk of subsequent hypothyroidism (HR 4.64 [95% CI 2.88-7.46]) and T1DM (HR 2.50 [95% CI 0.94-6.66]), the latter not statistically significant. Risk of hypothyroidism was higher in males (HR 20.00; 95% CI 5.64-70.87) than females (HR 3.21; 95% CI 1.85-5.57) (P value <.01). No differences were observed between males and females risks for diabetes or age at CD diagnosis. The small number of hyperthyroidism cases identified precluded any statistical analysis. CONCLUSIONS:Children and youth with CD are at increased risk of developing autoimmune hypothyroidism and to some extent T1DM. This suggests the need for surveillance of children with CD in order to timely detect the onset of such comorbidities.
Authors: Stefano Bibbò; Giovanni Mario Pes; Paolo Usai-Satta; Roberta Salis; Sara Soro; Bianca Maria Quarta Colosso; Maria Pina Dore Journal: Medicine (Baltimore) Date: 2017-11 Impact factor: 1.817