Long-term coeliac disease influences risk of death in patients with type 1 diabetes

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Long-term coeliac disease influences risk of death in patients with type 1 diabetes

Mollazadegan, K (author): Karolinska Institutet,Karolinska Institute, Sweden

Sanders, D S. (author): Royal Hallamshire Hospital, England,Gastroenterol & Liver Unit, Royal Hallamshire Hosp, Sheffield, England; Univ Sheffield, Sheffield, England

Ludvigsson, Johnny (author): Karolinska Institutet,Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kliniska vetenskaper,Hälsouniversitetet,Barn- och ungdomskliniken i Linköping,Dept Clin & Expt Med, Div Pediat, Linköping Univ, Linköping, Sweden; Pediat Clin, Linköping Univ Hosp, Linköping, Sweden,Karolinska Institute, Sweden

Ludvigsson, Jonas F. (author): Region Örebro län,Dept Med, Clin Epidemiol Unit, Karolinska Inst, Stockholm, Sweden; Dept Pediat, Örebro University Hospital, Örebro, Sweden

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2013-06-12
2013
English.
In: Journal of Internal Medicine. - : Wiley-Blackwell. - 0954-6820 .- 1365-2796. ; 274:3, s. 273-280

Related links:: https://urn.kb.se/re...; show more...; https://doi.org/10.1...; https://urn.kb.se/re...; http://kipublication...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Aim. The aim of this study was to examine mortality in patients with both type 1 diabetes (T1D) and coeliac disease (CD). less thanbrgreater than less thanbrgreater thanMethods. Between 1969 and 2008, we identified individuals with CD through biopsy reports from all pathology departments (n = 28) in Sweden. T1D was defined as a diagnosis of diabetes recorded in the Swedish National Patient Register between 1964 and 2009 in individuals aged andlt;= 30 years. During follow-up, we identified 960 patients with both T1D and CD. For each individual with T1D and CD, we selected up to five subjects with T1D alone (i.e. no CD), matched for sex, age and calendar period of diagnosis, as the reference group (n = 4608). Using a stratified Cox regression analysis with CD as a time-dependent covariate, we estimated the risk of death in patients with both T1D and CD compared with those with T1D alone. less thanbrgreater than less thanbrgreater thanResults. Stratifying for time since CD diagnosis, CD was not a risk factor for death in patients with T1D during the first 5 years after CD diagnosis [hazard ratio (HR) 0.87, 95% confidence interval (CI) 0.43-1.73], but thereafter the HR for mortality increased as a function of follow-up time (5 to andlt;10 years, HR 1.44, 95% CI 0.74-2.79; 10 to andlt;15 years, HR 1.88, 95% CI 0.81-4.36). Having a CD diagnosis for andgt;= 15 years was associated with a 2.80-fold increased risk of death in individuals with T1D (95% CI 1.28-6.12). less thanbrgreater than less thanbrgreater thanConclusion. A diagnosis of CD for andgt;= 15 years increases the risk of death in patients with T1D.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)

Keyword

cause-specific death
coeliac disease
cohort studies
mortality
type 1 diabetes
MEDICINE
MEDICIN

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art (subject category)

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