Vol 5, No 4 (2004): Practical Diabetology
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Published online: 2004-07-21

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Younger age at onset and sex predict celiac disease in children and adolescents with type 1 diabetes. An Italian multicenter study

Franco Cerutti, Graziella Bruno, Francesco Chiarelli, Renata Lorini, Franco Meschi, Carla Sachetti, The Diabetes Study Group of Italian Soci Endocrinology, Diabetology
Diabetologia Praktyczna 2004;5(4):209-216.

Abstract

INTRODUCTION. 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.
MATERIAL 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 ± 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 < 4 years than in those age > 9 years; and 3) girls have a higher risk of having both diseases than boys.

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