[Prevalence of type 1 diabetes-specific autoantibodies and of certain HLA patterns in celiac disease].
OBJECTIVE
An association between type 1 diabetes mellitus and celiac disease has been known for some time. One in ten type 1 diabetics have immunological markers for celiac disease (CD). But is there, conversely, an increased risk of CD for diabetics? This study was undertaken to answer this question by determining diabetes-associated antibodies and genetic factors in patients with a gluten-sensitive enteropathy (CD).


METHODS
68 patients with CD (48 females and 20 males) were investigated by determining the diabetes-associated serological marker GADA (glutamic acid decarboxylase antibodies). 1A-2A (insulinoma-associated protein 2 antibodies), ICA (Islet cell antibodies) and IAA (insulin autoantibodies). Among this cohort were 60 patients up to the age of 25 years and eight adults (average age 41.7 years). In 36 of these patients the HLA was also determined.


RESULTS
GADA was found in 6 patients (9%), 1A-2A in eight (12%) and IAA in 21. ICA were not demonstrated in any. Five of the CD patients were positive for several markers. One child, positive for autoantibodies already had manifest diabetes at the time of investigation. None of the patients with autoantibodies had an abnormal glucose metabolism one year later. HLA-DR3, that occurs in both CD and diabetes, was demonstrated in 78% of the patients with CD. The most common constellation, HLA-DR3-DQ2/HLA-DR7-DQ2, was found in 31%.


CONCLUSIONS
This investigation indicates a genetic association between celiac disease and diabetes. Nonetheless, the risk of developing diabetes mellitus is only minimally higher in patients with CD than in the normal population. Therefore, general screening cannot be recommended at present. Further studies will be needed.
Schilling
I
I
Klinik und Poliklinik für Kinder- und Jugendmedizin des Universitätsklinikums Carl Gustav Carus, Dresden.
Conrad
K
K
Füssel
M
M
Henker
J
J
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D002446:Celiac Disease / Q000201:enzymology* / Q000235:genetics / Q000276:immunology; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000201:enzymology* / Q000235:genetics / Q000276:immunology; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006683:HLA-DQ Antigens / Q000097:blood*; D006684:HLA-DR Antigens / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors
D001323:Autoantibodies; D006683:HLA-DQ Antigens; D006684:HLA-DR Antigens; D005968:Glutamate Decarboxylase