Celiac Disease Does Not Influence Fracture Risk in Young Patients with Type 1 Diabetes
Open accessAbstract
Objectives To examine the risk of any fractures in patients with both type 1 diabetes (T1D) and celiac disease (CD) vs patients with T1D only. Study design We performed a population-based cohort study. We defined T1D as individuals aged ≤30 years who had a diagnosis of diabetes recorded in the Swedish National Patient Register between 1964 and 2009. Individuals with CD were identified through biopsy report data between 1969 and 2008 from any of Sweden's 28 pathology departments. Some 958 individuals had both T1D and CD and were matched for sex, age, and calendar period with 4598 reference individuals with T1D only. We then used a stratified Cox regression analysis, where CD was modeled as a time-dependent covariate, to estimate the risk of any fractures and osteoporotic fractures (hip, distal forearm, thoracic and lumbar spine, and proximal humerus) in patients with both T1D and CD compared with that in patients with T1D only. Results During follow-up, 12 patients with T1D and CD had a fracture (1 osteoporotic fracture). CD did not influence the risk of any fracture (adjusted hazard ratio = 0.77; 95% CI = 0.42-1.41) or osteoporotic fractures (adjusted hazard ratio = 0.46; 95% CI = 0.06-3.51) in patients with T1D. Stratification for time since CD diagnosis did not affect risk estimates. Conclusion Having a diagnosis of CD does not seem to influence fracture risk in young patients with T1D. Follow-up in this study was, however, too short to ascertain osteoporotic fractures which traditionally occur in old age.
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The risk of fractures and nephropathy was not found to be higher in patients with both celiac disease and type 1 diabetes compared to isolated type 1 diabetes.
“On the other hand, the risk of fractures and nephropathy was not found to be higher in patients with both CD and T1D compared to isolated T1D (125, 128, 131).”
From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [125]
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ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease.
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- Authors
- Reilly, N. R., Lebwohl, B., Mollazadegan, K., Michaëlsson, K., Green, P. H. R., & Ludvigsson, J. F.
- Affiliations
- Columbia University Irving Medical Center (US)
- Karolinska Institutet (SE)
- Uppsala University (SE)
- Örebro University (SE)
- Corresponding author
- Ludvigsson, Jonas F.
- Venue
- The Journal of Pediatrics
- Publisher
- Elsevier BV
- Published
- 2016-02
- Volume
- 169
- Pages
- 49-54
- ISSN
- 0022-3476 (ISSN-L)
- PMC
- PMC4729630
- OpenAlex
- W2212504147
- Cited by
- 10
- References
- 50
- Citations by year
- 2025: 1 · 2024: 1 · 2022: 1 · 2020: 1 · 2019: 1 · 2018: 4 · 2017: 1
- FWCI
- 1.74
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000040)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- celiac disease, type 1 diabetes, fracture risk, osteoporotic fractures, young adults, bone health, comorbidities
- MeSH terms
- Adolescent, Adult, Celiac Disease, Child, Child, Preschool, Diabetes Mellitus, Type 1, Female, Humans, Infant, Infant, Newborn, Male, Cohort Studies, Risk Assessment, Fractures, Bone, Young Adult
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