Younger age at onset and sex predict celiac disease in children and adolescents with type 1 diabetes: an Italian multicenter study

OBJECTIVE— To estimate the prevalence of biopsy-confirmed celiac disease in Italian children and adolescents with type 1 diabetes and to assess whether age at onset of type 1 diabetes is independently associated with diagnosis of celiac disease. RESEARCH DESIGNANDMETHODS— The study group was a clinic-based cohort of children and adolescents with type 1 diabetes cared for in 25 Italian centers for childhood diabetes. Yearly screening for celiac disease was performed using IgA/IgG anti-gliadin and IgA anti-endomysium antibodies. RESULTS— Of the 4,322 children and adolescents (age 11.8 4.2 years) identified with type 1 diabetes, biopsy-confirmed celiac disease was diagnosed in 292 (prevalence 6.8%, 95% confidence interval [CI] 6.0 –7.6), with a higher risk seen in girls than in boys (odds ratio [OR] 1.93, 1.51–2.47). In 89% of these, diabetes was diagnosed before celiac disease. In logistic regression analyses, being younger at onset of diabetes, being female, and having a diagnosis of a thyroid disorder were independently associated with the risk of having diabetes and celiac disease. In comparison with subjects who were older than 9 years at onset of diabetes, subjects who were younger than 4 years at onset had an OR of 3.27 (2.20–4.85). CONCLUSIONS— We have provided evidence that 1) the prevalence of biopsy-confirmed celiac disease in children and adolescents with type 1 diabetes is high (6.8%); 2) the risk of having both diseases is threefold higher in children diagnosed with type 1 diabetes at age 4 years than in those age 9 years; and 3) girls have a higher risk of having both diseases than boys

Geographic variation in the frequency of abdominal adiposity and metabolic syndrome in Italian adolescents with type 1 diabetes.

we explored whether the frequency of abdominal adiposity and consequently of metabolic syndrome (MetSy) also varied across the different geographic areas in Italian adolescents with T1DM.This cross-sectional study included a total of 412 Italian adolescents of Caucasian origin (219 males) with T1DM, aged 16\u201319 years, with a duration of diabetes of 8.4\ub13.9 years.All patients were on multi-injection or pump insulin treatment; the daily insulin dose (ID) per body surface area was calculated. MetSy was defined according to the IDF criteria; all patients were considered to fulfill the criterion of hyperglycemia. Abdominal adiposity (W/h <0.5) was found in 116 patients (28.1 %) and MetSy in 39 patients (9.5 %). The highest frequencies of both abdominal adiposity and MetSy were found in patients living in southern Italy. No difference in BMI and daily ID was found among patients living in the three geographic areas, while HbA1c levels differed between patients living in the northern and central regions. In addition, patients with MetSy living in the North had not only significantly higher ID and worse HbA1c than patients without MetSy, but also higher ID (p=0.022) and worse HbA1c (p= 0.012) than patients with MetSy living in the south