Type 1 Diabetes and Microscopic Colitis
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Type 1 Diabetes and Microscopic Colitis

A Nationwide Matched Case-control Study in Sweden

Xiaoying Kang; Shengxin Liu; Bjorn Roelstraete; Hamed Khalili; Jonas F. Ludvigsson

Disclosures

Aliment Pharmacol Ther. 2023;57(12):1423-1431. 

In This Article

Abstract and Introduction

Abstract

Background and Aims: Microscopic colitis (MC) is a colonic inflammatory condition associated with autoimmune dysfunction. Type 1 diabetes (T1D) is a chronic disease induced by autoimmune destruction of pancreatic β-cells. We aimed to examine the association between T1D and MC.

Methods: A matched case–control study was conducted using the nationwide ESPRESSO cohort as study base. All biopsy-confirmed MC patients born after 1940 were identified and compared to biopsy-free individuals matched from the general population for T1D diagnosis using the Swedish National Patient Register. The T1D-MC association was estimated as odds ratios (ORs) and 95% confidence intervals (CIs) by conditional logistic models, considering differences by sex and MC subtype. Full sibling comparison and adjustment for MC-associated medications were also performed.

Results:We identified 352 (3.7%) and 945 (2.0%) T1D diagnoses from 9,600 MC cases and 47,870 matched population controls, respectively, which corresponded to an overall OR of 1.79 (95% CI: 1.56–2.05). The association was stronger for collagenous colitis (OR, 2.15; 95% CI: 1.70–2.71) than lymphocytic colitis (OR, 1.62; 95% CI: 1.37–1.92) and remained statistically significant in full sibling comparison (OR, 1.46; 95%: 1.18–1.81). Medication adjustment attenuated the association to null among females (OR: 1.02; 95% CI: 0.82–1.27) but not among males (OR: 1.45; 95% CI: 1.11–1.90).

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