In the Journals

Risk for additional autoimmune diseases substantial for women, white adults with type 1 diabetes

Among those with type 1 diabetes, white adults and women are at a significantly higher risk for developing additional autoimmune diseases as they age vs. other subgroups, according to findings published in the Journal of Diabetes.

“Although [type 1 diabetes] is classically defined as a disease of childhood, recent research finds that the life expectancy for patients with [type 1 diabetes] is well into the seventh decade due to advances in technology and therapy for glucose control,” Yicheng K. Bao, a medical student from the department of medicine at the University of Missouri-Kansas City School of Medicine, and colleagues wrote. “Thus, it is imperative for the literature to expand data on these patients as they age so clinicians can adequately assess all comorbidities.”

Using data from the HealthFacts patient registry, the researchers conducted a cross-sectional study of 158,865 adults with type 1 diabetes (mean age, 51.4 years; 52.5% women; 73.3% white; 21.8% black; 2.3% Hispanic; 1.7% Asian; 0.9% Native American). This total was estimated to be about 16% of the U.S. adult population with type 1 diabetes, according to the researchers.

Among the more than 30 autoimmune diseases identified in the population, thyroid disease (20.1%), systemic rheumatic diseases (3.4%) and gastrointestinal autoimmune disease (1.4%) were the most prevalent in the study population.

Women made up the majority of adults with hypothyroidism (69%; P < .0001), hyperthyroidism (69%; P < .0001), alopecia (79%; P < .0001), celiac disease (64%; P < .0001), rheumatoid arthritis (73%; P < .0001), lupus (82%; P < .0001) and Sjögren’s syndrome (87%; P < .0001). The prevalence of multiple occurrences of autoimmune disease was higher in women as well (OR = 2.43; 95% CI, 2.37-2.5), with 25% having at least one additional autoimmune disease compared with 14% of men.

“Of particular interest, 30% of women in our cohort experienced an additional [autoimmune disease], underscoring the importance of monitoring for additional [autoimmune diseases] in women with [type 1 diabetes],” the researchers wrote. “Compared with the prevalence of other complications of diabetes, the risk of acquiring an additional [autoimmune disease] is substantial.”

The researchers also observed a link between ethnicity and multiple autoimmune disease susceptibility in the population. White adults, who had a 26.1% rate of prevalence, were used as the reference for the study. The researchers noted that African-Americans (OR = 0.47; 95% CI, 0.45-0.49), Native Americans (OR = 0.49; 95% CI, 0.42-0.58), Asians (OR = 0.68; 95% CI, 0.61-0.75) and Hispanics (OR = 0.63; 95% CI, 0.57-0.69) had lower ORs for additional autoimmune disease compared with white adults.

Additionally, ORs for multiple autoimmune diseases increased with increasing age. Adults aged 30 to 39 years had an OR of 1.56 (95% CI, 1.48-1.65), whereas those aged at least 80 years had an OR of 2.81 (95% CI, 2.65-2.98) compared with those younger than 30 years.

“People with [type 1 diabetes] are at increased risk of both endocrine and non-endocrine [autoimmune disease], suggesting that loss of immune tolerance may not be unique to endocrine diseases,” the researchers wrote. “The risk of autoimmunity should be considered as an additional complication of [type 1 diabetes].” – by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures.

Among those with type 1 diabetes, white adults and women are at a significantly higher risk for developing additional autoimmune diseases as they age vs. other subgroups, according to findings published in the Journal of Diabetes.

“Although [type 1 diabetes] is classically defined as a disease of childhood, recent research finds that the life expectancy for patients with [type 1 diabetes] is well into the seventh decade due to advances in technology and therapy for glucose control,” Yicheng K. Bao, a medical student from the department of medicine at the University of Missouri-Kansas City School of Medicine, and colleagues wrote. “Thus, it is imperative for the literature to expand data on these patients as they age so clinicians can adequately assess all comorbidities.”

Using data from the HealthFacts patient registry, the researchers conducted a cross-sectional study of 158,865 adults with type 1 diabetes (mean age, 51.4 years; 52.5% women; 73.3% white; 21.8% black; 2.3% Hispanic; 1.7% Asian; 0.9% Native American). This total was estimated to be about 16% of the U.S. adult population with type 1 diabetes, according to the researchers.

Among the more than 30 autoimmune diseases identified in the population, thyroid disease (20.1%), systemic rheumatic diseases (3.4%) and gastrointestinal autoimmune disease (1.4%) were the most prevalent in the study population.

Women made up the majority of adults with hypothyroidism (69%; P < .0001), hyperthyroidism (69%; P < .0001), alopecia (79%; P < .0001), celiac disease (64%; P < .0001), rheumatoid arthritis (73%; P < .0001), lupus (82%; P < .0001) and Sjögren’s syndrome (87%; P < .0001). The prevalence of multiple occurrences of autoimmune disease was higher in women as well (OR = 2.43; 95% CI, 2.37-2.5), with 25% having at least one additional autoimmune disease compared with 14% of men.

“Of particular interest, 30% of women in our cohort experienced an additional [autoimmune disease], underscoring the importance of monitoring for additional [autoimmune diseases] in women with [type 1 diabetes],” the researchers wrote. “Compared with the prevalence of other complications of diabetes, the risk of acquiring an additional [autoimmune disease] is substantial.”

The researchers also observed a link between ethnicity and multiple autoimmune disease susceptibility in the population. White adults, who had a 26.1% rate of prevalence, were used as the reference for the study. The researchers noted that African-Americans (OR = 0.47; 95% CI, 0.45-0.49), Native Americans (OR = 0.49; 95% CI, 0.42-0.58), Asians (OR = 0.68; 95% CI, 0.61-0.75) and Hispanics (OR = 0.63; 95% CI, 0.57-0.69) had lower ORs for additional autoimmune disease compared with white adults.

Additionally, ORs for multiple autoimmune diseases increased with increasing age. Adults aged 30 to 39 years had an OR of 1.56 (95% CI, 1.48-1.65), whereas those aged at least 80 years had an OR of 2.81 (95% CI, 2.65-2.98) compared with those younger than 30 years.

“People with [type 1 diabetes] are at increased risk of both endocrine and non-endocrine [autoimmune disease], suggesting that loss of immune tolerance may not be unique to endocrine diseases,” the researchers wrote. “The risk of autoimmunity should be considered as an additional complication of [type 1 diabetes].” – by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures.