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Long-term coeliac disease influences risk of death in patients with type 1 diabetes
Karolinska Inst, Dept Med, Clin Epidemiol Unit, S-17176 Stockholm, Sweden.;Karolinska Inst, St Erik Eye Hosp, Stockholm, Sweden..
Royal Hallamshire Hosp, Gastroenterol & Liver Unit, Sheffield S10 2JF, S Yorkshire, England.;Univ Sheffield, Sheffield, S Yorkshire, England..
Linkoping Univ, Dept Clin & Expt Med, Div Pediat, Linkoping, Sweden.;Linkoping Univ Hosp, Pediat Clin, S-58185 Linkoping, Sweden..
Orebro University Hospital. Karolinska Inst, Dept Med, Clin Epidemiol Unit, S-17176 Stockholm, Sweden.;Orebro Univ Hosp, Dept Pediat, Orebro, 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). Methods. 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 <= 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. Results. 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 <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 T1D (95% CI 1.28-6.12). Conclusion. A diagnosis of CD for >= 15 years increases the risk of death in patients with T1D.

Place, publisher, year, edition, pages
2013. Vol. 274, no 3, 273-280 p.
Keyword [en]
cause-specific death, coeliac disease, cohort studies, mortality, type 1 diabetes
National Category
Family Medicine
Identifiers
URN: urn:nbn:se:oru:diva-56639DOI: 10.1111/joim.12092ISI: 000322907600008PubMedID: 23700968OAI: oai:DiVA.org:oru-56639DiVA: diva2:1083400
Available from: 2017-03-21 Created: 2017-03-21 Last updated: 2017-03-24Bibliographically approved

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