High prevalence of systemic rheumatic diseases in women with type 1 diabetes
Introduction
Type 1 diabetes mellitus (T1DM) is frequently associated with other endocrine and non-endocrine autoimmune diseases due to shared genetic predispositions.1., 2., 3. However, we have limited insight into the epidemiology of autoimmune diseases in older adults with T1DM. Data on the prevalence of systemic rheumatic diseases (SRDs) in persons with T1DM is particularly scarce.
Systemic rheumatic diseases, including rheumatoid arthritis, scleroderma, and systemic vasculitides, are debilitating conditions that disproportionately affect women. Having an SRD in addition to T1DM may further complicate care of both conditions, and may worsen cardiovascular and metabolic bone disease risks.4 Several studies have suggested a genetic link between SRDs and T1DM.5., 6., 7. We now aim to better characterize the prevalence, risk factors, and ages of onset of SRDs in a cohort of patients with T1DM.
Section snippets
Methods
This observational, cross-sectional study was approved by the Washington University Human Research Protection Office. Patients with T1DM seen at the Washington University Diabetes Center from 2011 to 2018 completed a questionnaire including date of birth, gender, race, age of T1DM onset, concurrent SRD diagnoses, and age of onset of each SRD. Patient charts were reviewed for verification.
Study population
Participants included 1212 individuals with T1DM, mean age 46.8 ± 16.2 years, range 19–96. Participants were 51.8% female; 89.6% white, 9.0% black, and 1.4% other race/ethnicity. Median T1DM onset age was 18.0 years, mean 21.2 ± 14.4 years. 6.5% of the cohort had a SRD, and of these, 63.3% had one or more non-SRD autoimmune diseases, such as hypothyroidism, hyperthyroidism, pernicious anemia, and celiac disease. Having T1DM plus SRD significantly raised the risk of additional autoimmune
Discussion
This study has three main findings: 1) SRD prevalence is high among persons with T1DM, 2) women with T1DM are at higher risk than men, and 3) individuals with T1DM and SRD are more likely to have additional AID than those without an SRD. Prior studies of AID prevalence in T1DM cohorts have reported low prevalence of SRD, generally under 2% (single or overall SRD).8,9 However, the mean age of these cohorts is <20 years. In contrast, our cohort with a mean age of 46 years demonstrated
Acknowledgements
This work was supported by the Washington University Diabetes Research Center (DRC) through NIH grant P30 DK020579 (to J.B.M.), the Doris Duke Charitable Foundation grant #2015215 (to J.W.H.) and NIH training grant T32DK007120 (to Y.B., J.W.H.). We thank Mary Jane Clifton, Carol Recklein, and Garrett Pagano for administrative and data collection support. We thank Dr. Philip Miller, Professor of Biostatistics at Washington University School of Medicine, for helpful discussions of data analysis.
References (11)
- et al.
Clinical profile of coexisting conditions in type 1 diabetes mellitus patients
Diabetes Metab Syndr
(2012) - et al.
Detecting shared pathogenesis from the shared genetics of immune-related diseases
Nat Rev Genet
(2009) - et al.
Emerging patterns of genetic overlap across autoimmune disorders
Genome Med
(2012) - et al.
Overlapping genetic susceptibility variants between three autoimmune disorders: rheumatoid arthritis, type 1 diabetes and coeliac disease
Arthritis Res Ther
(2010) - et al.
Prevalence and clinical prediction of osteoporosis in a contemporary cohort of patients with rheumatoid arthritis
Rheumatology (Oxford)
(2014)
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