Prevalence and Risk Factors of Autoimmune Thyroid and Coeliac Disease in Type 1 Diabetes Children and Adolescents; A Retrospective Cohort Analysis.

Abstract

Aim: To determine the prevalence and risk factors for autoimmune thyroiditis (AITD) and coeliac disease (CD) in a T1D paediatric and adolescent population.

Methods: This was a retrospective cohort analysis of 300 children and adolescents attending a diabetes outpatient clinic from 2017 to 2023. Screening for AITD and CD was done every 1 to 2 years after diagnosis of T1D. Chi-square analysis and logistic regression models were used to analyse clinical differences between T1D and AITD/CD.

Results: The prevalence of AITD and CD in the cohort was 7.7% (n = 23) and 9.3% (n = 28) respectively. Higher rates of AITD were associated with female sex (p = 0.002) and having an additional autoimmune disease (p = 0.05). Subgroup analysis showed that Hashimoto's thyroiditis was associated with female sex (p = 0.02) while Graves' disease was associated with having an additional autoimmune disease (p = 0.047). Patients with AITD also had a lower mean height (p = 0.02) and higher BMI (p = 0.002) than patients without AITD. No significant differences were found in patients with CD. Female sex was associated with higher rates of having both AITD and CD (p = 0.01). Age of T1D onset, diabetic ketoacidosis, or autoimmune family history were not associated with either AITD or CD.

Conclusions: Our study showed that the prevalence of autoimmune diseases in T1D remains high, with more cases of CD compared to AITD in our paediatric cohort. Our study suggests that regular screening for AITD and CD in T1D patients remains important and should continue to occur after the detection of one autoimmune disease.