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lüll Specific association of type 1 diabetes mellitus with anti-cyclic citrullinated peptide-positive rheumatoid arthritis Liao KP; Gunnarsson M; Kallberg H; Ding B; Plenge RM; Padyukov L; Karlson EW; Klareskog L; Askling J; Alfredsson LArthritis Rheum 2009[Mar]; 60 (3): 653-60OBJECTIVE: The co-occurrence of autoimmune diseases such as rheumatoid arthritis (RA) and type 1 diabetes mellitus (DM) has been reported in individuals and families. In this study, the strength and nature of this association were investigated at the population level in a Swedish case-control cohort. METHODS: For this case-control study, 1,419 patients with incident RA diagnosed between 1996 and 2003 were recruited from university, public, and private rheumatology units throughout Sweden; 1,674 matched control subjects were recruited from the Swedish national population registry. Sera from the subjects were tested for the presence of antibodies to cyclic citrullinated peptide (anti-CCP), rheumatoid factor (RF), and the 620W PTPN22 allele. Information on a history of diabetes was obtained by questionnaire, telephone interview, and/or medical record review. The prevalence of type 1 DM and type 2 DM was compared between patients with incident RA and control subjects and further stratified for the presence of anti-CCP, RF, and the PTPN22 risk allele. RESULTS: Type 1 DM was associated with an increased risk of RA (odds ratio [OR] 4.9, 95% confidence interval [95% CI] 1.8-13.1), and this association was specific for anti-CCP-positive RA (OR 7.3, 95% CI 2.7-20.0), but not anti-CCP-negative RA. Further adjustment for the presence of PTPN22 attenuated the risk of anti-CCP-positive RA in patients with type 1 DM to an OR of 5.3 (95% CI 1.5-18.7). No association between RA and type 2 DM was observed. CONCLUSION: The association between type 1 DM and RA is specific for a particular RA subset, anti-CCP-positive RA. The risk of developing RA later in life in patients with type 1 DM may be attributed, in part, to the presence of the 620W PTPN22 allele, suggesting that this risk factor may represent a common pathway for the pathogenesis of these 2 diseases.|Adolescent[MESH]|Adult[MESH]|Aged[MESH]|Alleles[MESH]|Antibodies/blood/*immunology[MESH]|Arthritis, Rheumatoid/blood/genetics/*immunology[MESH]|Autoimmune Diseases/blood/genetics/immunology[MESH]|Case-Control Studies[MESH]|Diabetes Mellitus, Type 1/genetics/*immunology[MESH]|Diabetes Mellitus, Type 2/blood/genetics/immunology[MESH]|Female[MESH]|Genetic Predisposition to Disease[MESH]|Health Surveys[MESH]|Humans[MESH]|Interviews as Topic[MESH]|Male[MESH]|Middle Aged[MESH]|Peptides, Cyclic/*immunology[MESH]|Protein Tyrosine Phosphatase, Non-Receptor Type 22/genetics[MESH]|Rheumatoid Factor/blood/immunology[MESH]|Sweden[MESH]|Young Adult[MESH] |