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- Title
The Frequency of Undiagnosed Celiac Disease in Youth with Type 1 Diabetes and Its Association with Diabetic Retinopathy: The SEARCH for Diabetes in Youth Study.
- Authors
Brady, Ryan P.; Jensen, Elizabeth T.; Rigdon, Joseph; Crimmins, Nancy A.; Mallon, Daniel; Dolan, Lawrence M.; Imperatore, Giuseppina; Kahkoska, Anna R.; Mottl, Amy K.; Honor, Ann; Pettitt, David J.; Merjaneh, Lina; Dabelea, Dana; Shah, Amy S.
- Abstract
Aims. Celiac disease (CD) in adults with type 1 diabetes has been associated with increased cardiovascular risk and the earlier occurrence of diabetes-associated complications. In the Search for Diabetes in Youth study, we aimed to assess the frequency of CD and the potential for undiagnosed CD among youth with childhood onset type 1 diabetes. In addition, we assessed the burden of cardiovascular risk factors and diabetes-associated complications in youth with type 1 diabetes by CD status and IgA tissue transglutaminase autoantibody (tTGA) levels. Methods. 2,444 youths with type 1 diabetes completed a CD questionnaire and underwent tTGA testing. Integrating the celiac disease questionnaire and tTGA results for this cross-sectional analysis, participants were categorized as follows: (1) reported CD; (2) seropositive for CD (no reported CD and seropositive tTGA); and (3) type 1 diabetes only (comparison group: no reported CD and seronegative tTGA). Subanalyses were performed on those with no reported CD and tTGA ≥10x ULN, designated potentially undiagnosed CD. Cardiovascular risk factors and diabetes-associated complications were evaluated by CD status and tTGA levels utilizing a Poisson model to estimate relative risk. Results. Reported CD in youths with type 1 diabetes was 7%. Seropositivity for tTGA with no reported CD was present in 4%, and 1.2% had potentially undiagnosed CD. Youths with potentially undiagnosed CD had a 2.69x higher risk of diabetic retinopathy than comparison group. In addition, CD with tTGA <0.05 (controlled CD) was associated with lower HbA1c. Conclusions. Undiagnosed CD is likely present in youths with type 1 diabetes and potentially undiagnosed CD is associated with a higher risk of diabetic retinopathy. These findings indicate the importance of routine screening for CD in type 1 diabetes in youths.
- Subjects
CELIAC disease complications; CARDIOVASCULAR diseases risk factors; AUTOANTIBODIES; IMMUNOGLOBULINS; CROSS-sectional method; TYPE 1 diabetes; MEDICAL screening; COMPARATIVE studies; TRANSFERASES; QUESTIONNAIRES; DESCRIPTIVE statistics; RESEARCH funding; DIABETIC retinopathy; DISEASE risk factors; DISEASE complications; ADOLESCENCE
- Publication
Pediatric Diabetes, 2023, p1
- ISSN
1399-543X
- Publication type
Article
- DOI
10.1155/2023/9038795