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Long-term coeliac disease influences risk of death in patients with type 1 diabetes
Karolinska Institute, Sweden .
Royal Hallamshire Hospital, England .
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
Karolinska Institute, Sweden .
2013 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 274, no 3, 273-280 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Wiley-Blackwell , 2013. Vol. 274, no 3, 273-280 p.
Keyword [en]
cause-specific death, coeliac disease, cohort studies, mortality, type 1 diabetes
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-97234DOI: 10.1111/joim.12092ISI: 000322907600008OAI: diva2:646171

Funding Agencies|Swedish Society of Medicine||Swedish Research Council - Medicine|522-2A09-195|Sven Jerring Foundation||Orebro Society of Medicine||Karolinska Institutet||Orebro University Hospital||Clas Groschinsky Foundation||Juhlin Foundation||Majblomman Foundation||Uppsala-Orebro Regional Research Council||Swedish Celiac Society||

Available from: 2013-09-06 Created: 2013-09-05 Last updated: 2013-09-06

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Ludvigsson, Johnny
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Division of Clinical SciencesFaculty of Health SciencesDepartment of Paediatrics in Linköping
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