title: Vascular risk factors in children, adolescents, and young adults with type 1 diabetes complicated by celiac disease: results from the DPV initiative.
abstract: OBJECTIVE
  Celiac disease (CD) is a common comorbidity of type 1 diabetes (T1D). Long-term consequences of CD are not completely understood, and adhering to a gluten-free diet is a burden for many patients. We investigated the effect of CD on vascular risk factors in a large cohort of T1D patients aged <20 yr.
  
  
  METHODS
  Within the longitudinal Diabetes Patienten Verlaufsdokumentation (DPV)-diabetes registry, data were analyzed from 59,909 < 20-yr-old T1D patients treated at 392 centers in Germany and Austria. A total of 974 patients with biopsy-proven celiac disease (BPCD) were compared with 28,398 patients without CD with respect to blood pressure (BP), lipids, glycohemoglobin (HbA1c ), body mass index (BMI), and reported smoking behavior.
  
  
  RESULTS
  Patients with T1D and BPCD showed significantly lower high-density lipoprotein (HDL) cholesterol levels [median (interquartile range): 53.0 (43.0-62.6) mg/dL] than patients without CD [55.0 (45.0-66.0) mg/dL; p < 0.01; p < 0.001 after adjustment for confounding variables]. Systolic BP was lower in patients with CD [105.5 (100.0-112.5) mmHg] than in patients without CD [110.0 (102.0-117.0) mmHg; p < 0.0001; p < 0.001 after adjustment]. There were no significant differences regarding smoking behavior, BMI, or HbA1c . In a subgroup of 335 patients with BPCD, HDL cholesterol was measured 1 yr after diagnosis of CD:HDL increased by 8% (p < 0.01).
  
  
  CONCLUSIONS
  Young people with T1D and CD have lower HDL cholesterol values than patients without CD. As low HDL cholesterol is associated with vascular risk, our findings support screening for CD and monitoring of HDL cholesterol in young people with T1D.
authors: Department of Pediatrics, Klinikum rechts der Isar, Technische Universität München, München, Germany.|Institute of Diabetes Research, Helmholtz Zentrum München, and Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Neuherberg, Germany.|Forschergruppe Diabetes e.V., Neuherberg, Germany.
authors: Katharina
authors: K
authors: Warncke
authors: Department of Pediatrics, Klinikum rechts der Isar, Technische Universität München, München, Germany.
authors: Susanne
authors: S
authors: Liptay
authors: Department of Pediatrics, Medical University of Graz, Graz, Austria.
authors: Elke
authors: E
authors: Fröhlich-Reiterer
authors: Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, University of Ulm, Ulm, Germany.
authors: Nicole
authors: N
authors: Scheuing
authors: Department of children's diabetology, Children's Hospital Klinikum Kassel, Kassel, Germany.
authors: Martin
authors: M
authors: Schebek
authors: Children's Hospital Paderborn, Paderborn, Germany.
authors: Johannes
authors: J
authors: Wolf
authors: Department of Pediatrics and Neonatology, Saarland University Medical Center, Homburg/Saar, Germany.
authors: Tilman R
authors: TR
authors: Rohrer
authors: Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital Düsseldorf, Düsseldorf, Germany.
authors: Thomas
authors: T
authors: Meissner
authors: Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, University of Ulm, Ulm, Germany.
authors: Reinhard W
authors: RW
authors: Holl
mesh_terms: D000293:Adolescent; D001786:Blood Glucose; D001794:Blood Pressure; D015992:Body Mass Index; D002446:Celiac Disease / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D012042:Registries; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
chemical_list: D001786:Blood Glucose; D008055:Lipids
keywords: blood pressure; celiac disease; lipids; type 1 diabetes; vascular risk