Combined atherogenic effects of celiac disease and type 1 diabetes mellitus

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.