Patients with celiac disease have a lower prevalence of non-insulin-dependent diabetes mellitus and metabolic syndrome.
OBJECTIVE
We investigated whether risk for non-insulin-dependent diabetes mellitus (NIDDM) and metabolic syndrome are affected by celiac disease. We examined the prevalence of NIDDM and metabolic syndrome among adults with celiac disease, compared with matched controls.


METHODS
We assessed medical records of 840 patients with biopsy-proven celiac disease for diagnoses of NIDDM, hypertension, or hyperlipidemia; body mass index (BMI); lipid profile; and levels of glucose or glycosylated hemoglobin, to identify those with metabolic syndrome. Patients without celiac disease were matched for age, sex, and ethnicity (n = 840 controls). The prevalence of NIDDM and metabolic syndrome in the celiac disease cohort was compared with that of the controls and subjects included in the National Health and Nutrition Examination Survey.


RESULTS
Twenty-six patients with celiac disease (3.1%) had NIDDM compared with 81 controls (9.6%) (P < .0001). Similarly, the prevalence of metabolic syndrome was significantly lower among patients with celiac disease than controls (3.5% vs 12.7%; P < .0001). The mean BMI of patients with celiac disease was significantly lower than that of controls (24.7 vs 27.5; P < .0001). However, celiac disease was still associated with a lower risk of NIDDM, after controlling for BMI.


CONCLUSIONS
The prevalence of NIDDM and metabolic syndrome are lower among patients with celiac disease than in matched controls and the general population. These differences are not explained by differences in BMI. Studies are needed to determine the mechanisms by which celiac disease affects the risk for NIDDM and metabolic syndrome.
Celiac Center, Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. tok043@mail.harvard.edu
Toufic A
TA
Kabbani
Ciaran P
CP
Kelly
Rebecca A
RA
Betensky
Joshua
J
Hansen
Kumar
K
Pallav
Javier A
JA
Villafuerte-Gálvez
Rohini
R
Vanga
Rupa
R
Mukherjee
Aileen
A
Novero
Melinda
M
Dennis
Daniel A
DA
Leffler
D000328:Adult; D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002446:Celiac Disease / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult
D001786:Blood Glucose; D006442:Glycated Hemoglobin