Perinatal risk factors increase the risk of being affected by both type 1 diabetes and coeliac disease

Adlercreutz, Emma H.; Wingren, Carl Johan; Vincente, Raquel P.; Merlo, Juan; Agardh, Daniel

doi:10.1111/apa.12836

Cited by 47 publications

(48 citation statements)

References 31 publications

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“…Several studies have shown that spring/summer birth is more common in patients with CD compared with their healthy counterparts8–11 suggesting a role of seasonal exposures. A seasonal pattern has also been shown for type 1 diabetes,12 in children with a double diagnosis of CD and type 1 diabetes6 and, in other immune-mediated diseases 13. Viral infections have a seasonal pattern and have also been associated with increased CD5–14 15 and type 1 diabetes risk 16…”

Section: Introductionmentioning

confidence: 91%

Season and region of birth as risk factors for coeliac disease a key to the aetiology?

et al. 2016

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BackgroundCoeliac disease (CD) incidence has increased in recent decades, characterised by variations according to sex, age at diagnosis, year of birth, month of birth and region of birth. Genetic susceptibility and exposure to gluten are the necessary factors in CD aetiology, although several environmental factors are considered.MethodsA nationwide prospective cohort longitudinal study was conducted consisting of 1 912 204 children aged 0–14.9 years born in Sweden from 1991 to 2009. A total of 6569 children were diagnosed with biopsy-verified CD from 47 paediatric departments. Using Cox regression, we examined the association between CD diagnosis and season of birth, region of birth and year of birth.ResultsOverall, CD risk was higher for children born during spring, summer and autumn as compared with children born during winter: adjusted HR for spring 1.08 (95% CI 1.01 to 1.16), summer 1.10 (95% CI 1.03 to 1.18) and autumn 1.10 (95% CI 1.02 to 1.18). Increased CD risk was highest if born in the south, followed by central Sweden when compared with children born in northern Sweden. Children diagnosed at <2 years had an increased CD risk if born in spring while those diagnosed at 2–14.9 years the risk was increased for summer and autumn births. The birth cohort of 1991–1996 had increased CD risk if born during spring, for the 1997–2002 birth cohort the risk increased for summer and autumn births, while for the birth cohort of 2003–2009 the risk was increased if born during autumn.ConclusionsSeason of birth and region of birth are independently and jointly associated with increased risk of developing CD during the first 15 years of life. Seasonal variation in infectious load is the likely explanation.

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Section: Introductionmentioning

confidence: 91%

Season and region of birth as risk factors for coeliac disease a key to the aetiology?

et al. 2016

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“…While CD can certainly be lifesaving for indications such as placenta previa and uterine rupture, the growing use of CD has been under increasing scrutiny as data suggest that increased use of elective primary cesareans for low-risk pregnancies can be associated with increased morbidity and mortality to mother and child compared to spontaneous vaginal delivery (53). Further, and more relevant to this review, CD has been associated with range of immune-mediated diseases in the offspring, such as an increased risk for type 1 diabetes (54, 55), celiac disease (55), childhood and adult obesity (56–58), asthma (59, 60), and allergic disease (61, 62). CD may also be associated with susceptibility to infections, as CD born infants are more likely to be hospitalized for bronchitis throughout the first 2 years of life (63).…”

Section: Perinatal Medical Interventions Profoundly Alter the Newbornmentioning

confidence: 98%

Early-Life Host–Microbiome Interphase: The Key Frontier for Immune Development

2017

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Human existence can be viewed as an “animal in a microbial world.” A healthy interaction of the human host with the microbes in and around us heavily relies on a well-functioning immune system. As development of both the microbiota and the host immune system undergo rapid changes in early life, it is not surprising that even minor alterations during this co-development can have profound consequences. Scrutiny of existing data regarding pre-, peri-, as well as early postnatal modulators of newborn microbiota indeed suggest strong associations with several immune-mediated diseases with onset far beyond the newborn period. We here summarize these data and extract overarching themes. This same effort in turn sets the stage to guide effective countermeasures, such as probiotic administration. The objective of our review is to highlight the interaction of host immune ontogeny with the developing microbiome in early life as a critical window of susceptibility for lifelong disease, as well as to identify the enormous potential to protect and promote lifelong health by specifically targeting this window of opportunity.

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“…The same group noted that females had an increased risk of both T1D and CD (31). Hormones may also have a role, but there is a clear gap in knowledge of the role of sex in development of these related autoimmune conditions.…”

Section: Discussionmentioning

confidence: 94%

“…The role of perinatal environment and the microbiome is also under examination. Children born by cesarean delivery and during summer months have been reported to be at increased risk for both T1D and CD (31). …”

Section: Discussionmentioning

confidence: 99%

Incidence of Type 1 Diabetes Is Not Increasing in a Population-Based Cohort in Olmsted County, Minnesota, USA

Cartee

Owens

Lahr

et al. 2016

Mayo Clinic Proceedings

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Context Worldwide studies show that the type 1 diabetes (T1D) incidence is increasing by 3% annually. Objectives We investigated the recent incidence of T1D in a US Midwestern county to determine whether this increase has been sustained and compare to celiac disease (CD) incidence. The prevalence of (CD), an associated autoimmune disease, within the cohort was also investigated. Design A broad search strategy was used to identify all cases of T1D in Olmsted County, Minnesota, between January 1,1994 and December 31, 2010 using the Rochester Epidemiology Project. Diagnosis and residency status were confirmed through the medical record. Incidence rates were directly standardized to the 2010 United States population. Poisson regression was used to test for a change in incidence rate. Clinical charts were reviewed to confirm case status. Setting Population-based study in Olmsted County, Minnesota. Main Outcome Measure The trend in T1D incidence in a population-based study in a Midwestern US county. Results There were 233 incident cases of T1D. Directly adjusting for age and sex with respect to the 2010 US white population, the overall annual incidence of T1D was 9.2 (95% CI, 8.0-10.4) per 100,000 people per year among all ages and 19.9 (95% CI, 16.6-23.2) per 100,000 per people per year for those younger than 20 years. There was no significant increase in the incidence of T1D over time (P=.45). Despite the overall stability in annual incidence, there was an initial increasing trend followed by a plateau. Of the 109 T1D patients (46%) tested for CD, 12% had biopsy-proven CD. Conclusions The incidence of T1D has stopped increasing in Olmsted County, Minnesota, in the most recent decade. Further studies are needed to confirm this finding and explore reasons for this plateau.

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Perinatal risk factors increase the risk of being affected by both type 1 diabetes and coeliac disease

Abstract: The increased risk of being affected by a double diagnosis of type 1 diabetes and coeliac disease was modulated by perinatal risk factors. This suggests that early life events are important when it comes to children with type 1 diabetes also developing coeliac disease.

Cited by 47 publications

References 31 publications

Season and region of birth as risk factors for coeliac disease a key to the aetiology?

Season and region of birth as risk factors for coeliac disease a key to the aetiology?

Early-Life Host–Microbiome Interphase: The Key Frontier for Immune Development

Incidence of Type 1 Diabetes Is Not Increasing in a Population-Based Cohort in Olmsted County, Minnesota, USA

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