June 01, 2017
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Coexisting celiac disease, type 1 diabetes reduce height in children

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Children with both celiac disease and type 1 diabetes had a lower height standard deviation score than children with type 1 diabetes alone, according to findings published in Diabetes Care.

Maria E. Craig, MBBS, MMedSc, PhD, FRACP , professor in the School of Women’s and Children’s Health at the University of New South Wales and the Children’s Hospital at Westmead in Sydney, and colleagues evaluated data from the Prospective Diabetes Follow-up registry (DPV), the T1D Exchange Clinic Network (T1DX), the National Paediatric Diabetes Audit (NPDA) and the Australasian Diabetes Data Network (ADDN) on 52,771 children (mean age, 13.2 years; 52.3% boys) with a clinical visit between April 2013 and March 2014. Researchers sought to determine international differences in celiac disease prevalence and clinical characteristics of those with both celiac disease and type 1 diabetes vs. type 1 diabetes alone.

Overall, 3.5% of participants had biopsy-proven celiac disease; prevalence was higher in girls (4.3%) compared with boys (2.7%; P < .001) and in those who were younger than 5 years at diabetes diagnosis (4.8%) compared with those who were older (2.8%; P < .001). The prevalence of celiac disease was highest in the ADDN (7.7%), followed by the NPDA (3.8%), DPV (3.2%) and T1DX (1.9%).

Participants with coexisting celiac disease and diabetes had a younger median age at diabetes diagnosis (5.4 years) compared with those with diabetes alone (7 years; P < .001). Fewer participants with celiac disease were nonwhite compared with those with diabetes alone (15% vs. 18%; P < .001).

Height standard deviation score (SDS) was lower in participants with coexisting celiac disease compared with those with diabetes alone (0.36 vs. 0.48; adjusted P < .001) after adjustment for age, sex and diabetes duration.

Overweight/obesity prevalence was lower in participants with coexisting celiac disease compared with those with diabetes alone (34% vs. 37%; adjusted P < .001).

“The findings support universal screening for [celiac disease] in patients with type 1 diabetes, particularly within the first 2 years after the diagnosis of diabetes, irrespective of ethnicity,” the researchers wrote. “Although the lower height SDS in those with [celiac disease] warrants further investigation using longitudinal data and documentation of adherence to the gluten-free diet, the observation emphasizes the importance of monitoring growth and nutrition in this population.” – by Amber Cox

Disclosure: Craig reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.