Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland.
Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm University, Ulm, Germany.
J Diabetes. 2021 Jun;13(6):448-457. doi: 10.1111/1753-0407.13126. Epub 2020 Nov 30.
Children with type 1 diabetes (T1D) are at much higher risk of developing celiac disease (CD) than the general population. The aim of the study was to assess the prevalence and differences in clinical presentation of CD in T1D in different regions of the world.
This study is based on the Better control in Pediatric and Adolescent diabeteS: Working to crEate cEnTers of Reference (SWEET) database. There were 57 375 patients included in the study, aged ≤18 years from 54 SWEET centers. Only centers with screening for celiac disease were included. Regression models adjusted for age, diabetes duration, and gender and a fixed effect in the models for region was used. Diabetes duration, age at diabetes onset, and sex were presented as unadjusted results.
CD was present in 2652 subjects (4.5%), with different prevalence among regions: from 1.9% in Asia/Middle East to 6.9% in Australia/New Zealand. CD was observed more often among females. Comparing children with and without CD, characteristics for those with CD were younger age at diabetes onset (6.3 [3.3; 9.8] vs 8.1 [4.6; 11.3], P < 0.001) and had longer diabetes duration (6.4 [3.6; 9.8] vs 4.8 [2.1; 8.2], P < 0.001). Further, they had lower glycosylated hemoglobin (HbA1c) in Europe and North America/Canada; lower body mass index (BMI)-SD score (BMI-SDS) in southern Europe, North America, and Canada; In most regions daily insulin dose was lower, height-SDS was lower, and the percentage of insulin pump users was higher in children with T1D and CD.
The prevalence and the anthropometric and metabolic consequences of CD in children with T1D differ around the world.
1 型糖尿病（T1D）患儿患乳糜泻（CD）的风险明显高于一般人群。本研究旨在评估世界各地 T1D 患儿 CD 的患病率和临床表现差异。
本研究基于改善儿科和青少年糖尿病控制：建立参考中心（SWEET）数据库。该研究纳入了来自 54 个 SWEET 中心的 57375 名年龄≤18 岁的患者。仅纳入了开展 CD 筛查的中心。使用年龄、糖尿病病程和性别调整的回归模型，并在模型中采用区域固定效应。糖尿病病程、发病年龄和性别以未经调整的结果呈现。
2652 例（4.5%）患儿存在 CD，不同地区的患病率不同：亚洲/中东为 1.9%，澳大利亚/新西兰为 6.9%。CD 更常见于女性。与无 CD 的患儿相比，有 CD 的患儿发病年龄更小（6.3[3.3；9.8] vs 8.1[4.6；11.3]，P<0.001），糖尿病病程更长（6.4[3.6；9.8] vs 4.8[2.1；8.2]，P<0.001）。此外，欧洲和北美/加拿大的糖化血红蛋白（HbA1c）水平较低，南欧、北美和加拿大的体质指数（BMI）-标准差评分（BMI-SDS）较低；大多数地区 CD 患儿的胰岛素日剂量较低、身高-SDS 较低，胰岛素泵使用者的比例较高。
世界各地 T1D 患儿 CD 的患病率及其对人体测量学和代谢的影响存在差异。
