Association of coexisting celiac disease with macrovascular and microvascular complications in adults with type 2 diabetes mellitus: a retrospective propensity score-matched cohort study.

IF 3.3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Pub Date : 2026-09-28 DOI:10.1007/s12020-026-04769-3

Renan Prado, Melissa Lou Silva

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引用次数: 0

Abstract

Background: Celiac disease (CD) and type 2 diabetes mellitus (T2DM) are increasingly recognized as overlapping metabolic conditions. However, the impact of concomitant CD on diabetes-related complications and metabolic outcomes in patients with T2DM remains poorly characterized. We aimed to compare clinical outcomes between patients with T2DM and CD versus patients without CD.

Methods: We performed a retrospective multicenter electronic health record (EHR)-based cohort study using the TriNetX research network. Adults with T2DM and concomitant CD were identified using ICD-10-CM codes for T2DM and CD, along with either markedly elevated tissue transglutaminase IgA levels or upper endoscopy procedures. Propensity score matching (1:1) was performed for demographics, cardiovascular risk factors, lipid disorders, medications, and laboratory markers, yielding 8,760 patients per cohort. Outcomes included albuminuria, depression, anxiety, severe hyperglycemia, ophthalmic complications, hospitalization, neuropathy, nephropathy, and a composite cardiovascular outcome.

Results: After matching, patients with T2DM and CD had significantly higher hazards of albuminuria (HR 1.30, 95% CI 1.15-1.46), depression (HR 1.14, 95% CI 1.07-1.21), anxiety (HR 1.12, 95% CI 1.06-1.18), severe hyperglycemia (HR 1.39, 95% CI 1.27-1.53), ophthalmic complications (HR 1.77, 95% CI 1.55-2.02), neuropathy (HR 1.73, 95% CI 1.59-1.88), nephropathy (HR 1.13, 95% CI 1.04-1.22), and a composite cardiovascular outcome (HR 1.09, 95% CI 1.01-1.17) compared with matched controls. Hospitalization risk did not differ between cohorts (HR 0.97, 95% CI 0.92-1.01). Mean follow-up after matching were 1,574 days and 1,438 days.

Conclusions: Among patients with T2DM, concomitant CD was associated with significantly higher risks of macro and microvascular diabetic complications, and psychiatric comorbidities.

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成人2型糖尿病患者并发乳糜泻与大血管和微血管并发症的相关性：一项回顾性倾向评分匹配队列研究

背景：乳糜泻（CD）和2型糖尿病（T2DM）越来越被认为是重叠的代谢疾病。然而，T2DM患者伴发CD对糖尿病相关并发症和代谢结局的影响仍不清楚。我们的目的是比较T2DM合并CD患者与非CD患者的临床结果。方法：我们使用TriNetX研究网络进行了一项基于电子健康记录（EHR）的回顾性多中心队列研究。使用ICD-10-CM编码对T2DM和CD的成人患者进行鉴定，同时使用组织转谷氨酰胺酶IgA水平显著升高或上端内窥镜检查。对人口统计学、心血管危险因素、脂质紊乱、药物和实验室标记物进行倾向评分匹配（1:1），每个队列产生8,760例患者。结果包括蛋白尿、抑郁、焦虑、严重高血糖、眼科并发症、住院、神经病变、肾病和复合心血管结果。结果：匹配后，T2DM和CD患者发生蛋白尿（HR 1.30, 95% CI 1.15-1.46）、抑郁（HR 1.14, 95% CI 1.07-1.21）、焦虑（HR 1.12, 95% CI 1.06-1.18）、严重高血糖（HR 1.39, 95% CI 1.27-1.53）、眼科并发症（HR 1.77, 95% CI 1.55-2.02）、神经病变（HR 1.73, 95% CI 1.59-1.88）、肾病（HR 1.13, 95% CI 1.04-1.22）和心血管综合结局（HR 1.09, 95% CI 1.01-1.17）的风险明显高于匹配对照组。住院风险在队列间无差异（HR 0.97, 95% CI 0.92-1.01）。配对后平均随访1574天和1438天。结论：在T2DM患者中，合并CD与糖尿病大、微血管并发症和精神合并症的风险显著增高相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.