Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Kreiner, V.
Associated Autoimmune Diseases in Children and Adolescents with Type 1 Diabetes at the Department of Paediatrics and Adolescent Medicine of the Medical University Graz
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2018. pp. 94
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Fröhlich-Reiterer Elke
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- Abstract:
- Background: Type 1 diabetes (T1D) is the most common chronic metabolic disease in children and adolescents, associated with a variety of additional autoimmune diseases, including autoimmune thyroid disease (AITD), celiac disease (CD), autoimmune gastritis (AG) and Addison’s disease (AD). Undiagnosed, these associated diseases can lead to comorbidities such as impaired growth, delayed puberty, poor metabolic control and many more complications. The aim of this study was to assess the prevalence of associated autoimmune disease in T1D patients at the Department of Paediatrics and Adolescent Medicine of the Medical University Graz and whether it changed substantially since 2008, as well as to analyse differences in age at diagnosis of the additional autoimmune disease, gender and the duration of diabetes at the time of diagnosis. Materials and Methods: A retrospective analysis of 303 children and adolescents (128 females, 175 males) diagnosed with T1D before the age of 18 years, at an average age of 7.1 ± 4.2 years and treated at the Diabetes Outpatient Clinic at the Department of Paediatrics and Adolescent Medicine of the Medical University Graz was performed. Data collected for every patient included gender, date of birth, date of diabetes onset, age at diabetes onset, family history of autoimmune disease and in patients with an additional autoimmune disease, date and age when antibodies were positive. Results: Of the 303 children and adolescents with T1D, 62 patients (20.5%) developed an additional autoimmune disease. Females (27%) had a significantly higher prevalence of associated autoimmune diseases than males (14%, P < 0.001). Since 2008, the prevalence has risen by almost 30%, however without reaching statistical significance (P = 0.339). AITD was present in 35 youths (11.6%), with a significant female predominance (24 female, 11 males, P = 0.028). 33 patients (10.9%) developed Hashimoto thyroiditis (HT) and two patients (0.6%) had Graves’ disease (GD). On average AITD was diagnosed at an age of 9.6 ± 4.2 years and 2.3 ± 2.9 years after T1D onset. CD was diagnosed in 25 children and adolescents (8.3%), showing a significant rise since 2008 (3.2%, P = 0.035). Average age at diagnosis of CD was 6.8 ± 4 years and 75% of patients were diagnosed under the age of 10 years (P = 0.014). Mean diabetes duration was 0.6 ± 1.7 years and no significant gender differences were found. AG was present in 9 patients (3%), with an average age at diagnosis after the onset of puberty (13 ± 2.6 years) and 6.4 ± 4.6 years after T1D onset. No correlation between AG and gender was found. Conclusion: The high prevalence of associated autoimmune diseases in children and adolescents with T1D, as well as the great variation in average age at diagnosis of the different autoimmune diseases, highlights the importance of routine screening procedures for early recognition and prevention of life-threatening complications.