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, 11 (4), 273-279

High Prevalence of Comorbid Autoimmune Diseases in Adults With Type 1 Diabetes From the HealthFacts Database

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High Prevalence of Comorbid Autoimmune Diseases in Adults With Type 1 Diabetes From the HealthFacts Database

Yicheng K Bao et al. J Diabetes.

Abstract

Background: Patients with type 1 diabetes (T1D) are at risk for other autoimmune diseases (ie, polyautoimmunity). The prevalence and risk factors of this phenomenon have been underreported in adults and ethnic minorities, and data are lacking regarding non-endocrine autoimmune diseases.

Methods: Study population data were gathered from HealthFacts, a deidentified patient database compiled from electronic medical records systems in the US. Patients with an International Classification of Diseases diagnosis code specifying T1D were included in the study, whereas those with a diagnosis of type 2 diabetes were excluded.

Results: The cross-sectional study cohort comprised 158 865 adults with T1D (mean [±SD] age 51.4 ± 18.9 years, 52.5% female). The most common autoimmune diseases were thyroid disease (20.1%), systemic rheumatic diseases (3.4%), rheumatoid arthritis specifically (2.0%), and gastrointestinal autoimmune diseases (1.4%). Most of the autoimmune diseases were more common in women (eg hypothyroidism, hyperthyroidism, celiac disease, rheumatoid arthritis, lupus, and Sjögren syndrome). Caucasians were more likely than other ethnicities to have an additional autoimmune disease. The prevalence of autoimmune diseases increased with increasing age, significantly in women, such that 38.5% of women over 80 years of age had an additional autoimmune disease, compared with 17.9% of women aged ≤29 years.

Conclusions: Additional autoimmunity represents a significant comorbidity in patients with T1D. Autoimmune diseases are more common in Caucasians and in women, and increase with age. Clinicians treating patients with T1D should be aware of the risk factors for additional autoimmune diseases.

摘要: 背景 1型糖尿病患者同时合并其他自身免疫性疾病(亦即多发性自身免疫)的风险很高。这种现象在成年人与少数民族中的患病率以及危险因素既往报导的不多, 并且有关非内分泌自身免疫性疾病的数据也很少。 方法 所用的研究人群数据来源于HealthFacts数据库, 这是一个由美国电子病历系统汇编而成并且去除了身份识别信息的患者数据库。这项研究纳入了国际疾病分类诊断代码为1型糖尿病的患者, 并且排除了诊断为2型糖尿病的患者。 结果 这项横断面研究队列纳入了158865名成年1型糖尿病患者(平均[±SD]年龄为51.4 ± 18.9岁,52.5%为女性)。最常见的自身免疫疾病是甲状腺疾病(20.1%)、全身性风湿疾病(3.4%)、类风湿性关节炎(2.0%)以及胃肠道自身免疫性疾病(1.4%)。大部分自身免疫性疾病都多见于女性(如甲状腺功能减退、甲状腺功能亢进、乳糜泻、类风湿性关节炎、狼疮与Sjögren综合征)。白种人与其他种族相比, 更有可能患上其他自身免疫性疾病。自身免疫性疾病的患病率随着年龄的增长不断增加, 在女性中更为明显, 如80岁以上的女性中有38.5%都会合并一种其他的自身免疫疾病, 而年龄≤ 29岁的女性中患病率只有17.9%。 结论 1型糖尿病患者容易合并其他自身免疫性疾病。自身免疫性疾病在白种人与女性中更为常见, 并且患病率随着年龄而不断增加。临床医生在治疗1型糖尿病患者时应该意识到患者可能有其他自身免疫性疾病的风险。.

Keywords: 1型糖尿病; autoimmune diseases; diabetes complications; epidemiology; polyautoimmunity; type 1 diabetes; 多发性自身免疫; 流行病学; 糖尿病并发症; 自身免疫性疾病.

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