Bybrant Mara Cerqueiro, Palmkvist Elsa, Söderström Hanna, Lindgren Marie, Hildebrand Hans, Norström Fredrik, Carlsson Annelie
Pediatric Endocrinology Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Science, Lund University, Lund, Sweden.
Acta Paediatr. 2023 Oct;112(10):2175-2181. doi: 10.1111/apa.16876. Epub 2023 Jul 9.
From 1986 to 1996, there was a four-fold increase in coeliac disease among young Swedish children, known as the Swedish coeliac epidemic. Children with type 1 diabetes have an increased risk of developing coeliac disease. We studied whether the prevalence of coeliac disease differed in children with type 1 diabetes born during and after this epidemic.
We compared national birth cohorts of 240 844 children born in 1992-1993 during the coeliac disease epidemic and 179 530 children born in 1997-1998 after the epidemic. Children diagnosed with both type 1 diabetes and coeliac disease were identified by merging information from five national registers.
There was no statistically significant difference in the prevalence of coeliac disease among children with type 1 diabetes between the two cohorts: 176/1642 (10.7%, 95% confidence interval 9.2%-12.2%) in the cohort born during the coeliac disease epidemic versus 161/1380 (11.7%, 95% confidence interval 10.0%-13.5%) in the post-epidemic cohort.
The prevalence of having both coeliac disease and type 1 diabetes was not significantly higher in children born during, than after, the Swedish coeliac epidemic. This may support a stronger genetic disposition in children who develop both conditions.
1986年至1996年期间,瑞典幼儿乳糜泻发病率增长了四倍,即所谓的瑞典乳糜泻流行。1型糖尿病患儿患乳糜泻的风险增加。我们研究了在这一流行期间及之后出生的1型糖尿病患儿中乳糜泻的患病率是否存在差异。
我们比较了1992 - 1993年乳糜泻流行期间出生的240844名儿童和1997 - 1998年流行之后出生的179530名儿童的全国出生队列。通过合并五个国家登记处的信息,确定同时患有1型糖尿病和乳糜泻的儿童。
两个队列中1型糖尿病患儿的乳糜泻患病率无统计学显著差异:乳糜泻流行期间出生的队列中为176/1642(10.7%,95%置信区间9.2% - 12.2%),流行后队列中为161/1380(11.7%,95%置信区间10.0% - 13.5%)。
在瑞典乳糜泻流行期间出生的儿童中,同时患有乳糜泻和1型糖尿病的患病率并不显著高于流行之后出生的儿童。这可能支持了同时患这两种疾病的儿童具有更强的遗传易感性。