Prevalence of celiac disease varied from 1.9 to 7.7 percent among children in U.S. and Australia
Children with type 1 diabetes often have comorbid celiac disease (CD), according to a study published online May 25 in Diabetes Care.
Maria E. Craig, M.B.B.S., Ph.D., from the Children's Hospital at Westmead in Sydney, and colleagues examined international differences in CD prevalence, and compared clinical characteristics of children with coexisting type 1 diabetes and CD versus type 1 diabetes only. Data were included for 52,721 individuals aged up to 18 years with a clinic visit between April 2013 and March 2014.
The researchers found that 3.5 percent of the participants had biopsy-confirmed CD, which was diagnosed at a median age of 8.1 years. The prevalence of CD varied, from 1.9 to 7.7 percent in the T1D Exchange Clinic Network (United States) and Australasian Diabetes Data Network (Australia), respectively. The age at diabetes diagnosis was younger for those with coexisting CD compared to those with type 1 diabetes only (5.4 versus 7.0 years of age; P < 0.001), while fewer children with coexisting CD were non-white (15 versus 18 percent; P < 0.001).
Those with CD had a lower height-standard deviation score (0.36 versus 0.48; adjusted P < 0.001), while fewer were overweight/obese (34 versus 37 percent; adjusted P < 0.001). The mean hemoglobin A1c values were comparable between the groups.
"Differences in CD prevalence may reflect international variation in screening and diagnostic practices, and/ or CD risk," the authors write. "Although glycemic control was not different, the lower height-standard deviation score supports close monitoring of growth and nutrition in this population."
Prevalence of Celiac Disease in 52,721 Youth With Type 1 Diabetes: International Comparison Across Three Continents
Maria E. Craig, Nicole Prinz, Claire T. Boyle, Fiona M. Campbell, Timothy W. Jones, Sabine E. Hofer, Jill H.Simmons, Naomi Holman, Elaine Tham, Elke Fröhlich-Reiterer, Stephanie DuBose, Helen Thornton, Bruce King, David M. Maahs, Reinhard W. Holl and Justin T. Warner
Celiac disease (CD) has a recognized association with type 1 diabetes. We examined international differences in CD prevalence and clinical characteristics of youth with coexisting type 1 diabetes and CD versus type 1 diabetes only.
RESEARCH DESIGN AND METHODS
Data sources were as follows: the Prospective Diabetes Follow-up registry (Germany/Austria); the T1D Exchange Clinic Network (T1DX) (U.S.); the National Paediatric Diabetes Audit (U.K. [England/Wales]); and the Australasian Diabetes Data Network (ADDN) (Australia). The analysis included 52,721 youths <18 years of age with a clinic visit between April 2013 and March 2014. Multivariable linear and logistic regression models were constructed to analyze the relationship between outcomes (HbA1c, height-standard deviation score [SDS], overweight/obesity) and type 1 diabetes/CD versus type 1 diabetes, adjusting for sex, age, and diabetes duration.
Biopsy-confirmed CD was present in 1,835 youths (3.5%) and was diagnosed at a median age of 8.1 years (interquartile range 5.3–11.2 years). Diabetes duration at CD diagnosis was <1 year in 37% of youths, >1–2 years in 18% of youths, >3–5 years in 23% of youths, and >5 years in 17% of youths. CD prevalence ranged from 1.9% in the T1DX to 7.7% in the ADDN and was higher in girls than boys (4.3% vs. 2.7%, P < 0.001). Children with coexisting CD were younger at diabetes diagnosis compared with those with type 1 diabetes only (5.4 vs. 7.0 years of age, P < 0.001) and fewer were nonwhite (15 vs. 18%, P < 0.001). Height-SDS was lower in those with CD (0.36 vs. 0.48, adjusted P < 0.001) and fewer were overweight/obese (34 vs. 37%, adjusted P < 0.001), whereas mean HbA1c values were comparable: 8.3 ± 1.5% (67 ± 17 mmol/mol) versus 8.4 ± 1.6% (68 ± 17 mmol/mol).
CD is a common comorbidity in youth with type 1 diabetes. Differences in CD prevalence may reflect international variation in screening and diagnostic practices, and/or CD risk. Although glycemic control was not different, the lower height-SDS supports close monitoring of growth and nutrition in this population.
www red DiabetologNytt