{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:57:40Z","timestamp":1785437860052,"version":"3.56.0"},"reference-count":47,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,11,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND AND OBJECTIVES:<\/jats:title><jats:p>Few birth cohorts have prospectively followed development of type 1 diabetes (T1D) and celiac disease (CD) autoimmunities to determine timing, extent of co-occurrence, and associated genetic and demographic factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>In this prospective birth cohort study, 8676 children at high genetic risk of both diseases were enrolled and 5891 analyzed in median follow-up of 66 months. Along with demographic factors and HLA-DR-DQ, genotypes for HLA-DPB1 and 5 non-HLA loci conferring risk of both T1D and CD were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Development of persistent islet autoantibodies (IAs) and tissue transglutaminase autoantibodies (tTGAs), as well as each clinical disease, was evaluated quarterly from 3 to 48 months of age and semiannually thereafter. IAs alone appeared in 367, tTGAs alone in 808, and both in 90 children. Co-occurrence significantly exceeded the expected rate. IAs usually, but not always, appeared earlier than tTGAs. IAs preceding tTGAs was associated with increasing risk of tTGAs (hazard ratio [HR]: 1.48; 95% confidence interval [CI]: 1.15\u20131.91). After adjusting for country, sex, family history, and all other genetic loci, significantly greater co-occurrence was observed in children with a T1D family history (HR: 2.80), HLA-DR3\/4 (HR: 1.94) and single-nucleotide polymorphism rs3184504 at SH2B3 (HR: 1.53). However, observed co-occurrence was not fully accounted for by all analyzed factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>In early childhood, T1D autoimmunity usually precedes CD autoimmunity. Preceding IAs significantly increases the risk of subsequent tTGAs. Co-occurrence is greater than explained by demographic factors and extensive genetic risk loci, indicating that shared environmental or pathophysiological mechanisms may contribute to the increased risk.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2017-1305","type":"journal-article","created":{"date-parts":[[2017,10,10]],"date-time":"2017-10-10T09:10:13Z","timestamp":1507626613000},"source":"Crossref","is-referenced-by-count":96,"title":["Co-occurrence of Type 1 Diabetes and Celiac Disease Autoimmunity"],"prefix":"10.1542","volume":"140","author":[{"given":"William","family":"Hagopian","sequence":"first","affiliation":[{"name":"Diabetes Programs Division, Pacific Northwest Research Institute, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye-Seung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Health Informatics Institute, University of South Florida, Tampa, 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