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Co-occurrence of Ty...
Co-occurrence of Type 1 Diabetes and Celiac Disease Autoimmunity
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- Hagopian, William (author)
- Pacific Northwest Research Institute
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- Lee, Hye Seung (author)
- University of South Florida
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- Liu, Edwin (author)
- University of Colorado
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- Rewers, Marian (author)
- University of Colorado
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- She, Jin Xiong (author)
- Medical College of Georgia
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- Ziegler, Anette G. (author)
- Helmholtz Zentrum München
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- Lernmark, Åke (author)
- Lund University,Lunds universitet,Celiaki och diabetes,Forskargrupper vid Lunds universitet,Celiac Disease and Diabetes Unit,Lund University Research Groups,Skåne University Hospital
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- Toppari, Jorma (author)
- Turku University Hospital
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- Rich, Stephen S. (author)
- University of Virginia
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- Krischer, Jeffrey P. (author)
- University of South Florida
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- Erlich, Henry (author)
- Children's Hospital Oakland Research Institute
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- Akolkar, Beena (author)
- National Institute of Diabetes and Digestive and Kidney Diseases
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- Agardh, Daniel (author)
- Lund University,Lunds universitet,Celiaki och diabetes,Forskargrupper vid Lunds universitet,Celiac Disease and Diabetes Unit,Lund University Research Groups,Skåne University Hospital
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(creator_code:org_t)
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- 2017-11-01
- 2017
- English.
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In: Pediatrics. - : American Academy of Pediatrics (AAP). - 1098-4275 .- 0031-4005. ; 140:5
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http://dx.doi.org/10...
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Abstract
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- BACKGROUND AND OBJECTIVES: Few birth cohorts have prospectively followed development of type 1 diabetes (T1D) and celiac disease (CD) autoimmunities to determine timing, extent of co-occurrence, and associated genetic and demographic factors.METHODS: In this prospective birth cohort study, 8676 children at high genetic risk of both diseases were enrolled and 5891 analyzed in median follow-up of 66 months. Along with demographic factors and HLA-DR-DQ, genotypes for HLA-DPB1 and 5 non-HLA loci conferring risk of both T1D and CD were analyzed.RESULTS: Development of persistent islet autoantibodies (IAs) and tissue transglutaminase autoantibodies (tTGAs), as well as each clinical disease, was evaluated quarterly from 3 to 48 months of age and semiannually thereafter. IAs alone appeared in 367, tTGAs alone in 808, and both in 90 children. Co-occurrence significantly exceeded the expected rate. IAs usually, but not always, appeared earlier than tTGAs. IAs preceding tTGAs was associated with increasing risk of tTGAs (hazard ratio [HR]: 1.48; 95% confidence interval [CI]: 1.15-1.91). After adjusting for country, sex, family history, and all other genetic loci, significantly greater co-occurrence was observed in children with a T1D family history (HR: 2.80), HLA-DR3/4 (HR: 1.94) and single-nucleotide polymorphism rs3184504 at SH2B3 (HR: 1.53). However, observed co-occurrence was not fully accounted for by all analyzed factors.CONCLUSIONS: In early childhood, T1D autoimmunity usually precedes CD autoimmunity. Preceding IAs significantly increases the risk of subsequent tTGAs. Co-occurrence is greater than explained by demographic factors and extensive genetic risk loci, indicating that shared environmental or pathophysiological mechanisms may contribute to the increased risk.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
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Pediatrics
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Hagopian, Willia ...
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Lee, Hye Seung
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Liu, Edwin
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Rewers, Marian
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She, Jin Xiong
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Ziegler, Anette ...
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show more...
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Lernmark, Åke
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Toppari, Jorma
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Rich, Stephen S.
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Krischer, Jeffre ...
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Erlich, Henry
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Akolkar, Beena
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Agardh, Daniel
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and Endocrinology an ...
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MEDICAL AND HEAL ...
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Pediatrics
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Lund University