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Association of insulin-dependent diabetes mellitus and celiac disease: a study based on serologic markers.

Abstract

BACKGROUND

The association of celiac disease and insulin-dependent diabetes mellitus has been known for some time. In an attempt to clarify this association, the prevalence of celiac disease among diabetic children was determined, and the risk of insulin-dependent diabetes mellitus was defined in pediatric patients with celiac disease.

METHODS

Ninety-three children with diabetes were analyzed for the presence of celiac disease-related markers (antigliadin and antiendomysial antibodies) and characteristic alterations in the intestinal mucosa. In another group, 93 children with celiac disease were screened for pancreatic autoantibodies and pancreatic beta-cell function.

RESULTS

Among children with insulin-dependent diabetes mellitus, a 6.45% prevalence of celiac disease was observed, a value significantly higher than that found among healthy controls. In contrast, only three celiac disease patients showed potential autoimmunity toward the pancreatic beta cell, a proportion not significantly different from that in the general population. Additionally, no alteration of glucose metabolism was observed in the antibody-positive patients.

CONCLUSION

The increased risk of celiac disease among patients with diabetes requires a long follow-up to determine the presence of celiac disease markers among patients with diabetes, to avoid potential malignant disease derived from untreated celiac disease. In contrast, there is no evidence to support an increased risk of insulin-dependent diabetes mellitus among children with celiac disease. In accordance with the accepted influence of diet in the development of autoimmune diabetes, a hypothetical mechanism of protection against insulin-dependent diabetes mellitus that is mediated by environmental factors related to restricted diet is suggested in this population.

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  • Authors+Show Affiliations

    ,

    Department of Pediatrics, Hospital de Cruces and Universidad del Pais Vasco, Bilbao, Basque Country, Spain.

    , , , ,

    Source

    MeSH

    Adolescent
    Antibodies
    Biomarkers
    Celiac Disease
    Child
    Diabetes Mellitus, Type 1
    Female
    Gliadin
    HLA-DR3 Antigen
    HLA-DR4 Antigen
    HLA-DR6 Antigen
    HLA-DR7 Antigen
    Humans
    Intestinal Mucosa
    Male

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    9669725

    Citation

    Vitoria, J C., et al. "Association of Insulin-dependent Diabetes Mellitus and Celiac Disease: a Study Based On Serologic Markers." Journal of Pediatric Gastroenterology and Nutrition, vol. 27, no. 1, 1998, pp. 47-52.
    Vitoria JC, Castaño L, Rica I, et al. Association of insulin-dependent diabetes mellitus and celiac disease: a study based on serologic markers. J Pediatr Gastroenterol Nutr. 1998;27(1):47-52.
    Vitoria, J. C., Castaño, L., Rica, I., Bilbao, J. R., Arrieta, A., & García-Masdevall, M. D. (1998). Association of insulin-dependent diabetes mellitus and celiac disease: a study based on serologic markers. Journal of Pediatric Gastroenterology and Nutrition, 27(1), pp. 47-52.
    Vitoria JC, et al. Association of Insulin-dependent Diabetes Mellitus and Celiac Disease: a Study Based On Serologic Markers. J Pediatr Gastroenterol Nutr. 1998;27(1):47-52. PubMed PMID: 9669725.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Association of insulin-dependent diabetes mellitus and celiac disease: a study based on serologic markers. AU - Vitoria,J C, AU - Castaño,L, AU - Rica,I, AU - Bilbao,J R, AU - Arrieta,A, AU - García-Masdevall,M D, PY - 1998/7/21/pubmed PY - 1998/7/21/medline PY - 1998/7/21/entrez SP - 47 EP - 52 JF - Journal of pediatric gastroenterology and nutrition JO - J. Pediatr. Gastroenterol. Nutr. VL - 27 IS - 1 N2 - BACKGROUND: The association of celiac disease and insulin-dependent diabetes mellitus has been known for some time. In an attempt to clarify this association, the prevalence of celiac disease among diabetic children was determined, and the risk of insulin-dependent diabetes mellitus was defined in pediatric patients with celiac disease. METHODS: Ninety-three children with diabetes were analyzed for the presence of celiac disease-related markers (antigliadin and antiendomysial antibodies) and characteristic alterations in the intestinal mucosa. In another group, 93 children with celiac disease were screened for pancreatic autoantibodies and pancreatic beta-cell function. RESULTS: Among children with insulin-dependent diabetes mellitus, a 6.45% prevalence of celiac disease was observed, a value significantly higher than that found among healthy controls. In contrast, only three celiac disease patients showed potential autoimmunity toward the pancreatic beta cell, a proportion not significantly different from that in the general population. Additionally, no alteration of glucose metabolism was observed in the antibody-positive patients. CONCLUSION: The increased risk of celiac disease among patients with diabetes requires a long follow-up to determine the presence of celiac disease markers among patients with diabetes, to avoid potential malignant disease derived from untreated celiac disease. In contrast, there is no evidence to support an increased risk of insulin-dependent diabetes mellitus among children with celiac disease. In accordance with the accepted influence of diet in the development of autoimmune diabetes, a hypothetical mechanism of protection against insulin-dependent diabetes mellitus that is mediated by environmental factors related to restricted diet is suggested in this population. SN - 0277-2116 UR - https://www.unboundmedicine.com/medline/citation/9669725/full_citation L2 - http://Insights.ovid.com/pubmed?pmid=9669725 DB - PRIME DP - Unbound Medicine ER -