Combined atherogenic effects of celiac disease and type 1 diabetes mellitus

Atherosclerosis. 2011 Aug;217(2):531-5. doi: 10.1016/j.atherosclerosis.2011.04.042. Epub 2011 May 6.

Abstract

Objective: Previous studies have shown a high cardiovascular risk in patients with autoimmune diseases, such as type 1 diabetes mellitus (T1DM). Conversely, few data are available about patients with celiac disease (CD). The aim of our study was to assess carotid intima-media thickness (c-IMT), in patients with T1DM, CD or both (T1DM+CD) as compared with age- and sex-matched healthy individuals (H).

Methods: We enrolled 120 patients, 30 with T1DM, 30 with CD, 30 with T1DM+CD and 30 H. Clinical, metabolic and anthropometric data were collected. All T1DM patients were on insulin while all CD patients were on a gluten-free diet. c-IMT was evaluated by high frequency linear digital ultrasound.

Results: c-IMT was significantly greater in patients with T1DM+CD than in patients with T1DM or CD (P<0.001 for both), while no difference was found between T1DM and CD. Moreover, c-IMT was greater in CD than in H (P<0.001). Glycemic control and disease duration were similar between T1DM+CD and T1DM. Lipid and anthropometric parameters were similar among groups. Furthermore, in a pooled multivariate analysis, only age and disease type were significantly correlated with c-IMT (P<0.001 for both).

Conclusion: Our study demonstrates that celiac patients have greater c-IMT as compared with healthy individuals. Thus, non-invasive monitoring of c-IMT in CD might be useful in preventing cardiovascular disease. Moreover, patients with T1DM+CD show more severe subclinical atherosclerosis as compared with those presenting T1DM or CD only, suggesting that the association of these autoimmune diseases might accelerate the atherosclerotic process.

MeSH terms

  • Adult
  • Age Factors
  • Analysis of Variance
  • Atherosclerosis / diagnostic imaging
  • Atherosclerosis / etiology*
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Case-Control Studies
  • Celiac Disease / complications*
  • Celiac Disease / diagnosis
  • Celiac Disease / diet therapy
  • Chi-Square Distribution
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diet, Gluten-Free
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Italy
  • Lipids / blood
  • Male
  • Regression Analysis
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Ultrasonography

Substances

  • Biomarkers
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin
  • Lipids
  • hemoglobin A1c protein, human
  • C-Reactive Protein