Celiac Disease Increases Risk of Thyroid Disease in Patients With Type 1 Diabetes: A Nationwide Cohort Study Featured Article: Matthew Kurien, Kaziwe Mollazadegan, David S. Sanders, and Jonas F. Ludvigsson Diabetes Care Volume 39: 371–375 March 2016

STUDY OBJECTIVE To examine if individuals with both type 1 diabetes (T1D) and celiac disease (CD) are at a higher risk of autoimmune thyroid disease (ATD) than those with only T1D Kurien M. et al. Diabetes Care 2016;39:371–375

STUDY DESIGN AND METHODS T1D was defined as having an inpatient or a hospital-based outpatient diagnosis of T1D at age ≤30 years (Swedish National Patient Register between 1964 and 2009) Data on CD were obtained through small intestinal biopsy reports showing villous atrophy ATD included hyperthyreosis and hypothyreosis 947 individuals with T1D and biopsy-verified CD were identified Subjects were matched to 4,584 control subjects with T1D but no CD Cox regression estimated the risk of ATD Kurien M. et al. Diabetes Care 2016;39:371–375

RESULTS Among T1D subjects, CD was a risk factor for later ATD 90 T1D+CD patients developed ATD Adjusting for sex, age, and calendar period, the corresponding hazard ratio (HR) was 1.67 This excess risk was highest in subjects with CD for ≥10 years Risk increases were seen in both males and females CD was a risk factor for both hypothyreosis and hyperthyreosis Kurien M. et al. Diabetes Care 2016;39:371–375

CONCLUSIONS Among patients with T1D, CD is a risk factor for the later development of ATD Kurien M. et al. Diabetes Care 2016;39:371–375