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- Title
Long-term coeliac disease influences risk of death in patients with type 1 diabetes.
- Authors
Mollazadegan, K.; Sanders, D. S.; Ludvigsson, J.; Ludvigsson, J. F.
- Abstract
Aim The aim of this study was to examine mortality in patients with both type 1 diabetes ( T1 D) and coeliac disease ( CD). Methods Between 1969 and 2008, we identified individuals with CD through biopsy reports from all pathology departments ( n = 28) in Sweden. T1 D was defined as a diagnosis of diabetes recorded in the Swedish National Patient Register between 1964 and 2009 in individuals aged ≤30 years. During follow-up, we identified 960 patients with both T1 D and CD. For each individual with T1 D and CD, we selected up to five subjects with T1 D 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 T1 D and CD compared with those with T1 D alone. Results Stratifying for time since CD diagnosis, CD was not a risk factor for death in patients with T1 D 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 <10 years, HR 1.44, 95% CI 0.74-2.79; 10 to <15 years, HR 1.88, 95% CI 0.81-4.36). Having a CD diagnosis for ≥15 years was associated with a 2.80-fold increased risk of death in individuals with T1 D (95% CI 1.28-6.12). Conclusion A diagnosis of CD for ≥15 years increases the risk of death in patients with T1 D.
- Subjects
CELIAC disease; TYPE 1 diabetes; DIAGNOSIS of diabetes; CONFIDENCE intervals; MORTALITY; REGRESSION analysis; REFERENCE groups; DIABETES risk factors
- Publication
Journal of Internal Medicine, 2013, Vol 274, Issue 3, p273
- ISSN
0954-6820
- Publication type
Article
- DOI
10.1111/joim.12092