[Diabetes mellitus type 1 and associated organ-specific autoimmunity].
Autoimmune type 1 diabetic patients show a high prevalence of thyroid peroxidase (TPO), parietal cell (PCA), anti-adrenal (AAA) and anti-endomysium antibodies (EmA-IgA), which may be accompanied with clinical disease. We studied the grade of associated organ-specific autoimmunity and the pattern of prevalence of TPO and PCA by age, gender, duration, age at onset of diabetes, and HLA DR haplotype in 783 type 1 diabetic patients, consisting of 286 children and 497 adults (M/F: 389/394), with a mean diabetes duration of 11.8 +/- 10.1 years. The relationship between islet cell (ICA), glutamic acid decarboxylase-65 (GADA) and thyro-gastric auto-antibodies was also investigated. TPO were present in 21.6%, PCA in 18.3%, AAA in 2.2% and EmA-IgA in 2.1% of the patients. The presence of TPO is determined by gender (p < 0.0001), age (P = 0.0008), and PCA status (p = 0.029). The presence of PCA is only influenced by age (p = 0.0027) and TPO status (p = 0.0155). Patients with ICA+ > or = 3 years had a higher prevalence of thyro-gastric auto-antibodies (p = 0.045) than ICA- subjects. Also, PCA were more prevalent in GADA+ than GADA- patients (p = 0.005). We observed an association between HLA DR5 and PCA (p = 0.0012). Dysthyroidism was more prevalent in TPO+ than TPO- subjects (p < 0.0001). PCA+ subjects had a higher prevalence of iron deficiency anaemia (p = 0.0099) and pernicious anaemia (p < 0.0001) than PCA- patients. In conclusion, particularly type 1 diabetic patients with persisting ICA > or = 3 years or with GADA, show a high prevalence of thyro-gastric auto-antibodies. Based on antibody-positivity we observed a high prevalence of thyroid disease, iron deficiency anaemia and pernicious anaemia, which can compromise the health of the diabetic patient.
De Block
C E
CE
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology / Q000276:immunology; D000752:Anemia, Pernicious / Q000453:epidemiology / Q000276:immunology; D001323:Autoantibodies / Q000032:analysis*; D015551:Autoimmunity; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000235:genetics / Q000276:immunology* / Q000503:physiopathology; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology; D007501:Iron / Q000097:blood; D007515:Islets of Langerhans / Q000276:immunology; D008274:Magnesium / Q000097:blood; D008297:Male; D009928:Organ Specificity / Q000276:immunology*; D010295:Parietal Cells, Gastric / Q000276:immunology; D015995:Prevalence; D012737:Sex Factors; D013959:Thyroid Diseases / Q000453:epidemiology / Q000276:immunology; D014805:Vitamin B 12 / Q000097:blood
D001323:Autoantibodies; D005968:Glutamate Decarboxylase; D006442:Glycated Hemoglobin; D007453:Iodide Peroxidase; D007501:Iron; D008274:Magnesium; D014805:Vitamin B 12