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Prevalence and predictive factors for celiac disease in children with type 1 diabetes. Whom and when to screen?A nationwide longitudinal cohort study of Swedish children

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posted on 2024-02-16, 19:03 authored by Marie Lindgren, Fredrik Norström, Martina Persson, Helena Elding Larsson, Gun Forsander, Karin Åkesson, Ulf Samuelsson, Johnny Ludvigsson, Annelie Carlsson

Objective: To examine the prevalence and predictive factors for celiac disease (CD) after a diagnosis of type 1 diabetes (T1D) in children and adolescent, to improve the current screening guidelines.

Research Design and Methods: The association between sex, age at T1D diagnosis, HLA, and diabetes autoantibodies, and a diagnosis of CD was examined in 5295 children with T1D from the Better Diabetes Diagnosis study in Sweden.

Results: The prevalence of biopsy-proven CD was 9.8%, of which 58.2% already had a CD diagnosis before or at T1D onset. Almost all, 95.9%, were diagnosed with CD within five years after T1D diagnosis. Younger age at T1D diagnosis and being homozygote for DQ2 increased the risk of CD after T1D, but neither sex nor diabetes-related autoantibodies were associated with the risk.

Conclusion: Age at and time after diabetes diagnosis should be considered in screening guidelines for CD in children with T1D.

Funding

The study was financed by grants from the Swedish state under the agreement between the Swedish government and the country councils, the ALF agreement 2018/2022 and by a grant from “the Swedish Diabetes Foundation (svenska diabetesstiftelsen) and from barndiabetesfonden.

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