ECE2017 Eposter Presentations: Adrenal and Neuroendocrine Tumours Adrenal cortex (to include Cushing's) (86 abstracts)
The relative risk of developing Addison’s disease among patients with type 1 diabetes mellitus: a nationwide, matched, observational cohort study
Dimitrios Chantzichristos 1, , Anders Persson 3 , Björn Eliasson 1, , Mervete Miftaraj 3 , Stefan Franzén 3 , Ann-Marie Svensson 3 & Gudmundur Johannsson 1,
1Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 2Department of Endocrinology-Diabetes-Metabolism, Sahlgrenska University Hospital, Gothenburg, Sweden; 3Department of Medicine, National Diabetes Register, Centre of Registers, University of Gothenburg, Gothenburg, Sweden.
Background: Both prevalence and incidence of type 1 diabetes (T1DM) is increasing. T1DM is associated with other autoimmune diseases, such as Addison’s disease (AD). This combination is rare, with estimated prevalence in Norway 20 per million. Having both DM & AD is associated with marked excess mortality.
Objectives: To study prevalence and incidence of AD among patients with and without T1DM.
Methods: Nationwide, observational study cross-referencing the Swedish National Diabetes Register with Inpatient Register in patients with T1DM & AD and matched controls from the general population (matched 1:5 for age, sex and country). Demographics at baseline, group proportions and time to AD diagnosis using a Cox proportional hazards model were assessed.
Results: Prevalence: Between 1987–2012, 105 subjects were diagnosed with AD among 30,685 patients with T1DM, while 32 among 153,918 controls. The odds ratio for AD in T1DM patients vs controls was therefore 16.5 (95% CI 11.1–24.5). The prevalence of AD in patients with and without T1DM was 3400 and 200 per million, respectively. Incidence: Between 1998-2013, 67 subjects were diagnosed with AD at a mean age of 36.7 years (SD 13.1) among 36,705 patients with T1DM, while 33 were diagnosed with AD at a mean age of 43.1 (SD 15.1) among 184,304 controls. The estimated relative risk increase to develop AD in T1DM patients was therefore 10.7 (95% CI 7.0–16.2). The incidence of AD for a patient with and without T1DM was 195 and 18 per million patient-years, respectively.
Conclusion: This nationwide study shows that prevalence of AD is higher than previously reported and that the incidence of AD for a patient with T1DM is 195 per million patient-years. T1DM patients have a more than 10-fold higher risk of developing AD than matched controls and their AD develops at a younger age.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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