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[Prognostic factors of celiac disease occurrence in type 1 diabetes mellitus children].

Abstract

INTRODUCTION

Discussion on the frequency of coexistent celiac disease and type 1 diabetes mellitus (DM1) as well as an attempt to standardize diagnostic methods of celiac disease detection among DM1 children have been performed.

OBJECTIVES

To assess the incidence of celiac disease among DM1 children in the Pomeranian region of Poland followed by analysis of the putative prognostic factors for celiac disease development in this particular group of children.

MATERIALS AND METHODS

70 children aged 9.47+/-4.59 (group 1) de novo diagnosed with DM1 and 223 children aged 10.20+/-3.87 with long-standing diabetes mellitus type 1 (4.47+/-3.16 years from the diagnosis) were enrolled in the study. All the patients had C-peptide, HbA1c, CRP, TSH, fT4, fT3, urinary albumin secretion rate, IgA, level of antigliadin antibodies (AGA), anti-tissue transglutaminase (TGA) IgA and IgG antibodies (ELISA), anti-endomysium (EmA) IgA and IgG antibodies (immunofluorescence) and anti-tyreoglobulin antibodies (TG), anti-thyroid peroxidase (TPO) antibodies (ELISA) evaluated. All the patients had jejunal biopsy and thyroid ultrasound examination.

RESULTS

5.7% of group 1 patients were diagnosed with celiac disease based on the positive jejunal biopsy in comparison with 9.4% in the group 2. TGA antibodies were present in 9.52% of group 2, AGA in 7.62%, EmA in 6.19%. 10% of group 1 children had autoimmune thyroiditis versus 24.2% of group 2 children. The group of children with coincident long-lasting DM1 and celiac disease (group A) was characterized by significantly earlier age at diagnosis (p=0.003), higher HbA(1)c (p=<0.001), CRP (p<0.001) and elevated urine albumin secretion in relation to children without celiac disease and autoimmune thyroiditis (group B). Serologic test detecting TGA antibodies was found to be the most sensitive (95.2%) for the detection of celiac disease among DM1 children, while the lowest sensitivity was obtained in the case of the EmA antibody test (61.9%).

CONCLUSIONS

The celiac disease morbidity confirmed by jejunal biopsy is high among DM1 children (9.4%). The assessment of the serum TGA appears to be the most sensitive screening marker for the celiac disease detection in DM1 children.

Authors+Show Affiliations

Klinika Pediatrii, Hematologii, Onkologii i Endokrynologii AM w Gdańsku, Gdańsk. mysliwiec@amg.gda.plNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

pol

PubMed ID

17239306

Citation

Myśliwiec, Małgorzata, et al. "[Prognostic Factors of Celiac Disease Occurrence in Type 1 Diabetes Mellitus Children]." Endokrynologia, Diabetologia I Choroby Przemiany Materii Wieku Rozwojowego : Organ Polskiego Towarzystwa Endokrynologow Dzieciecych, vol. 12, no. 4, 2006, pp. 281-5.
Myśliwiec M, Balcerska A, Stepiński J, et al. [Prognostic factors of celiac disease occurrence in type 1 diabetes mellitus children]. Endokrynol Diabetol Chor Przemiany Materii Wieku Rozw. 2006;12(4):281-5.
Myśliwiec, M., Balcerska, A., Stepiński, J., Bakowska, A., Jedrzejczyk, A., Bautembach-Minkowska, J., Sztangierska, B., Banach, P., & Wiśniewski, P. (2006). [Prognostic factors of celiac disease occurrence in type 1 diabetes mellitus children]. Endokrynologia, Diabetologia I Choroby Przemiany Materii Wieku Rozwojowego : Organ Polskiego Towarzystwa Endokrynologow Dzieciecych, 12(4), 281-5.
Myśliwiec M, et al. [Prognostic Factors of Celiac Disease Occurrence in Type 1 Diabetes Mellitus Children]. Endokrynol Diabetol Chor Przemiany Materii Wieku Rozw. 2006;12(4):281-5. PubMed PMID: 17239306.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Prognostic factors of celiac disease occurrence in type 1 diabetes mellitus children]. AU - Myśliwiec,Małgorzata, AU - Balcerska,Anna, AU - Stepiński,Jan, AU - Bakowska,Alicja, AU - Jedrzejczyk,Anna, AU - Bautembach-Minkowska,Joanna, AU - Sztangierska,Beata, AU - Banach,Piotr, AU - Wiśniewski,Piotr, PY - 2007/1/24/pubmed PY - 2007/3/9/medline PY - 2007/1/24/entrez SP - 281 EP - 5 JF - Endokrynologia, diabetologia i choroby przemiany materii wieku rozwojowego : organ Polskiego Towarzystwa Endokrynologow Dzieciecych JO - Endokrynol Diabetol Chor Przemiany Materii Wieku Rozw VL - 12 IS - 4 N2 - INTRODUCTION: Discussion on the frequency of coexistent celiac disease and type 1 diabetes mellitus (DM1) as well as an attempt to standardize diagnostic methods of celiac disease detection among DM1 children have been performed. OBJECTIVES: To assess the incidence of celiac disease among DM1 children in the Pomeranian region of Poland followed by analysis of the putative prognostic factors for celiac disease development in this particular group of children. MATERIALS AND METHODS: 70 children aged 9.47+/-4.59 (group 1) de novo diagnosed with DM1 and 223 children aged 10.20+/-3.87 with long-standing diabetes mellitus type 1 (4.47+/-3.16 years from the diagnosis) were enrolled in the study. All the patients had C-peptide, HbA1c, CRP, TSH, fT4, fT3, urinary albumin secretion rate, IgA, level of antigliadin antibodies (AGA), anti-tissue transglutaminase (TGA) IgA and IgG antibodies (ELISA), anti-endomysium (EmA) IgA and IgG antibodies (immunofluorescence) and anti-tyreoglobulin antibodies (TG), anti-thyroid peroxidase (TPO) antibodies (ELISA) evaluated. All the patients had jejunal biopsy and thyroid ultrasound examination. RESULTS: 5.7% of group 1 patients were diagnosed with celiac disease based on the positive jejunal biopsy in comparison with 9.4% in the group 2. TGA antibodies were present in 9.52% of group 2, AGA in 7.62%, EmA in 6.19%. 10% of group 1 children had autoimmune thyroiditis versus 24.2% of group 2 children. The group of children with coincident long-lasting DM1 and celiac disease (group A) was characterized by significantly earlier age at diagnosis (p=0.003), higher HbA(1)c (p=<0.001), CRP (p<0.001) and elevated urine albumin secretion in relation to children without celiac disease and autoimmune thyroiditis (group B). Serologic test detecting TGA antibodies was found to be the most sensitive (95.2%) for the detection of celiac disease among DM1 children, while the lowest sensitivity was obtained in the case of the EmA antibody test (61.9%). CONCLUSIONS: The celiac disease morbidity confirmed by jejunal biopsy is high among DM1 children (9.4%). The assessment of the serum TGA appears to be the most sensitive screening marker for the celiac disease detection in DM1 children. SN - 1234-625X UR - https://www.unboundmedicine.com/medline/citation/17239306/[Prognostic_factors_of_celiac_disease_occurrence_in_type_1_diabetes_mellitus_children]_ L2 - http://www.diseaseinfosearch.org/result/8214 DB - PRIME DP - Unbound Medicine ER -