Microvascular Complications in Childhood-Onset Type 1 Diabetes and Celiac Disease: A Multicenter Longitudinal Analysis of 56,514 Patients From the German-Austrian DPV Database
| Autor: | Rohrer, Tilman R, Wolf, Johannes, Liptay, Susanne, Zimmer, Klaus-Peter, Fröhlich-Reiterer, Elke, Scheuing, Nicole, Marg, Wolfgang, Stern, Martin, Kapellen, Thomas M, Hauffa, Berthold, Wölfle, Joachim, Holl, Reinhard W, for the DPV Initiative, the German BMBF Competence Network Diabetes Mellitus |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism Medizin Kaplan-Meier Estimate Gastroenterology Nephropathy Diet Gluten-Free chemistry.chemical_compound Risk Factors Germany Diabetes mellitus Internal medicine Internal Medicine medicine Albuminuria Humans Prospective Studies Age of Onset Risk factor Dyslipidemias Glycated Hemoglobin Advanced and Specialized Nursing Type 1 diabetes business.industry Incidence Hazard ratio Middle Aged medicine.disease Celiac Disease Diabetes Mellitus Type 1 chemistry Austria Hypertension Microvessels Immunology Female Glycated hemoglobin business Diabetic Angiopathies Dyslipidemia Retinopathy |
| Zdroj: | Diabetes Care. 38:801-807 |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/dc14-0683 |
| Popis: | OBJECTIVE To investigate whether celiac disease (CD) associated with type 1 diabetes increases the risk of microvascular complications. RESEARCH DESIGN AND METHODS Patients (n = 56,514) aged >10 years with diabetes duration RESULTS Kaplan-Meier analysis revealed that retinopathy and nephropathy occurred earlier in the presence versus absence of CD: retinopathy at age 26.7 years (95% CI 23.7–30.2) in 25% of patients with CD vs. age 33.7 years (33.2–34.4) in 25% without CD and microalbuminuria at age 32.8 years (29.7–42.5) vs. 42.4 years (41.4–43.3). The adjusted risk for both retinopathy (hazard ratio 1.263 [95% CI 1.078–1.481]) and nephropathy (1.359 [1.228–1.504]) was higher in patients with diabetes and CD versus those without CD. Cox regression revealed CD as an independent risk factor for microvascular complications after adjustment for confounders. CONCLUSIONS CD is an independent risk factor for retinopathy and nephropathy in patients with type 1 diabetes. Our study therefore supports the recommendation for regular serologic testing for CD, even in the absence of clinical CD. Further prospective studies are required to investigate whether a gluten-free diet might reduce the risk of microvascular disorders in patients with diabetes and CD. |
| Databáze: | OpenAIRE |
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