title: Celiac Disease and Risk of Autoimmune Disorders: A Population-Based Matched Birth Cohort Study.
abstract: OBJECTIVE
  To estimate the relative risk of developing type 1 diabetes mellitus (T1DM) and autoimmune thyroid disease in children with celiac disease (CD).
  
  
  METHODS
  A matched cohort design with linkage of administrative data was adopted. A total of 1215 cases of CD and 6075 references matched by sex and year of birth born in Friuli Venezia Giulia Region (Italy) between 1989 and 2011 were included. Cox regression models were used to estimate hazard ratios (HRs) for autoimmune diseases in patients with CD compared with references, stratified by sex and age at diagnosis.
  
  
  RESULTS
  Individuals with CD had an increased risk of subsequent hypothyroidism (HR 4.64 [95% CI 2.88-7.46]) and T1DM (HR 2.50 [95% CI 0.94-6.66]), the latter not statistically significant. Risk of hypothyroidism was higher in males (HR 20.00; 95% CI 5.64-70.87) than females (HR 3.21; 95% CI 1.85-5.57) (P value <.01). No differences were observed between males and females risks for diabetes or age at CD diagnosis. The small number of hyperthyroidism cases identified precluded any statistical analysis.
  
  
  CONCLUSIONS
  Children and youth with CD are at increased risk of developing autoimmune hypothyroidism and to some extent T1DM. This suggests the need for surveillance of children with CD in order to timely detect the onset of such comorbidities.
authors.affiliation: Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padua, Padua, Italy. Electronic address: cristina.canova@unipd.it.
authors.forename: Cristina
authors.initials: C
authors.lastname: Canova
authors.affiliation: Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padua, Padua, Italy.
authors.forename: Gisella
authors.initials: G
authors.lastname: Pitter
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.
authors.forename: Jonas F
authors.initials: JF
authors.lastname: Ludvigsson
authors.affiliation: Friuli-Venezia Giulia Regional Health Information System, Informatica per il Sistema degli Enti Locali (INSIEL) S.p.A., Udine, Italy.
authors.forename: Pierantonio
authors.initials: P
authors.lastname: Romor
authors.affiliation: Epidemiological Service, Health Directorate, Friuli Venezia-Giulia Region, Udine, Italy.
authors.forename: Loris
authors.initials: L
authors.lastname: Zanier
authors.affiliation: Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padua, Padua, Italy.
authors.forename: Renzo
authors.initials: R
authors.lastname: Zanotti
authors.affiliation: Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padua, Padua, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Simonato
mesh_terms: D000293:Adolescent; D000367:Age Factors; D016022:Case-Control Studies; D002446:Celiac Disease / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D005260:Female; D050031:Hashimoto Disease / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016016:Proportional Hazards Models; D012737:Sex Factors; D013967:Thyroiditis, Autoimmune / Q000453:epidemiology*; D055815:Young Adult
keywords: autoimmune thyroid disease; follow-up celiac disease; matched cohortstudy; type 1 diabetes mellitus