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[The prevalence of autoimmune thyroid disease and celiac disease in children and adolescents with type 1 diabetes mellitus].
Pediatr Endocrinol Diabetes Metab. 2008; 14(4):221-4.PE

Abstract

INTRODUCTION

Patients with type 1 diabetes mellitus have an increase the risk of developing other autoimmune diseases, among them, autoimmune thyroid disease, mainly Hashimoto are more frequently observed. The aim of the study was to assess the prevalence of celiac disease and autoimmune thyroiditis in children and adolescents with type 1 diabetes mellitus.

MATERIAL AND METHODS

The study included 260 children (124 girls, 136 boys) aged 1.3-18 years (mean 11+/-4.01), the diabetes duration 3.99+/-3.7 years. Endomysial antibody (EMA) was measured and all patients with positive EMA had small-bowel biopsy. Antibodies against thyroperoxidase (a-TPO), thyroglobulin (a-Tg), TSH, fT4, HbA1c and ultrasound examination of thyroid glands were assessed.

RESULTS

The prevalence of EMA was 10% (27/260) and 9% (25/260) had biopsy-proven celiac disease. The median age of T1DM at onset was significantly lower in patients with EMA than those without EMA 6.2+/-5.6 vs. 7.7+/-4.2 p=0.04. 20% of children diagnosed with type 1 diabetes at age <4 years had celiac disease p=0.001. The prevalence of thyroid antibodies was 29% (75/260). In the group with positive thyroid antibodies, in 28% (21/75) thyroid ultrasonography showed scattered hypoechogenicity and 23% (17/75) required treatment with thyroxine. Children with positive a-TPO had higher TSH level (2.87+/-2.1 vs. 1.95+/-0.9) p<0.01 and HbA1c level (8.32+/-1.64 vs. 7.59+/-1.67) p=0.03 than children without thyroid antibodies. More frequently thyroid antibodies were positive in girls than in boys.

CONCLUSIONS

Out of five patients with T1DM, one is diagnosed with Hashimoto or celiac disease. Both diseases occurred independently. Autoimmune thyroid disease and celiac disease occur more frequently in children with T1DM, therefore screening at an onset and repeated measurements are recommended.

Authors+Show Affiliations

ll Katedra Pediatrii Kliniki Diabetologii, Patologii Noworodka i Wad Wrodzonych Warszawskiego UM. agnieszka.szypowska@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

pol

PubMed ID

19239789

Citation

Szypowska, Agnieszka, et al. "[The Prevalence of Autoimmune Thyroid Disease and Celiac Disease in Children and Adolescents With Type 1 Diabetes Mellitus]." Pediatric Endocrinology, Diabetes, and Metabolism, vol. 14, no. 4, 2008, pp. 221-4.
Szypowska A, Błazik M, Groele L, et al. [The prevalence of autoimmune thyroid disease and celiac disease in children and adolescents with type 1 diabetes mellitus]. Pediatr Endocrinol Diabetes Metab. 2008;14(4):221-4.
Szypowska, A., Błazik, M., Groele, L., & Pańkowska, E. (2008). [The prevalence of autoimmune thyroid disease and celiac disease in children and adolescents with type 1 diabetes mellitus]. Pediatric Endocrinology, Diabetes, and Metabolism, 14(4), 221-4.
Szypowska A, et al. [The Prevalence of Autoimmune Thyroid Disease and Celiac Disease in Children and Adolescents With Type 1 Diabetes Mellitus]. Pediatr Endocrinol Diabetes Metab. 2008;14(4):221-4. PubMed PMID: 19239789.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [The prevalence of autoimmune thyroid disease and celiac disease in children and adolescents with type 1 diabetes mellitus]. AU - Szypowska,Agnieszka, AU - Błazik,Marlena, AU - Groele,Lidia, AU - Pańkowska,Ewa, PY - 2009/2/26/entrez PY - 2009/2/26/pubmed PY - 2009/4/1/medline SP - 221 EP - 4 JF - Pediatric endocrinology, diabetes, and metabolism JO - Pediatr Endocrinol Diabetes Metab VL - 14 IS - 4 N2 - INTRODUCTION: Patients with type 1 diabetes mellitus have an increase the risk of developing other autoimmune diseases, among them, autoimmune thyroid disease, mainly Hashimoto are more frequently observed. The aim of the study was to assess the prevalence of celiac disease and autoimmune thyroiditis in children and adolescents with type 1 diabetes mellitus. MATERIAL AND METHODS: The study included 260 children (124 girls, 136 boys) aged 1.3-18 years (mean 11+/-4.01), the diabetes duration 3.99+/-3.7 years. Endomysial antibody (EMA) was measured and all patients with positive EMA had small-bowel biopsy. Antibodies against thyroperoxidase (a-TPO), thyroglobulin (a-Tg), TSH, fT4, HbA1c and ultrasound examination of thyroid glands were assessed. RESULTS: The prevalence of EMA was 10% (27/260) and 9% (25/260) had biopsy-proven celiac disease. The median age of T1DM at onset was significantly lower in patients with EMA than those without EMA 6.2+/-5.6 vs. 7.7+/-4.2 p=0.04. 20% of children diagnosed with type 1 diabetes at age <4 years had celiac disease p=0.001. The prevalence of thyroid antibodies was 29% (75/260). In the group with positive thyroid antibodies, in 28% (21/75) thyroid ultrasonography showed scattered hypoechogenicity and 23% (17/75) required treatment with thyroxine. Children with positive a-TPO had higher TSH level (2.87+/-2.1 vs. 1.95+/-0.9) p<0.01 and HbA1c level (8.32+/-1.64 vs. 7.59+/-1.67) p=0.03 than children without thyroid antibodies. More frequently thyroid antibodies were positive in girls than in boys. CONCLUSIONS: Out of five patients with T1DM, one is diagnosed with Hashimoto or celiac disease. Both diseases occurred independently. Autoimmune thyroid disease and celiac disease occur more frequently in children with T1DM, therefore screening at an onset and repeated measurements are recommended. SN - 2081-237X UR - https://www.unboundmedicine.com/medline/citation/19239789/[The_prevalence_of_autoimmune_thyroid_disease_and_celiac_disease_in_children_and_adolescents_with_type_1_diabetes_mellitus]_ L2 - http://www.diseaseinfosearch.org/result/8214 DB - PRIME DP - Unbound Medicine ER -