[Risk markers for insulin-dependent diabetes mellitus and duration of exposure to gluten in celiac patients].
BACKGROUND
Celiac patients are at high risk of developing insulin-dependent diabetes mellitus, a condition that has a long pre-diabetic period. During this lapse, anti-islet cell antibodies serve as markers for future disease. This may be related with the duration of the exposure to gluten.


OBJECTIVE
To test the hypothesis that long term adherence to a gluten free diet decreases the frequency of risk markers for insulin dependent diabetes mellitus during adolescence and early adulthood.


METHODS
158 celiac patients were classified as: G1, (n=30 patients) studied at the time of diagnosis; G2 (n=97 patients) exposed to gluten as a result of non compliance with the gluten free diet and, G3 (n=31 patients) who had maintained a long term, strict gluten free diet. Isotype IgG anti-islet cell antibodies were detected by indirect immunofluorescence using monkey pancreas, results were reported in Juvenile Diabetes Foundation (JDF) units.


RESULTS
Celiac patients exposed to a gluten containing diet had a significantly higher prevalence of anti-islet cell antibodies than those who had been exposed only briefly (p < 0.017). In addition, a significantly higher prevalence of anti-islet cell antibodies was observed in those patients whose exposure to gluten was longer than 5 years than in those whose exposure was shorter (p < 0.02).


CONCLUSIONS
Celiac patients long exposed to gluten have a significantly higher prevalence of anti-islet cell antibodies than those exposed for a short period. This fact supports the hypothesis that the development of these antibodies is associated with the length of the exposure to gluten.
Unidad de Gastroenterología, División de Nutrición Humana, Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Macul 5540, Santiago, Chile. sverbeke@globalcom.cl
Sandra
S
Verbeke
Sylvia
S
Cruchet
Martín
M
Gotteland
Gloria
G
Ríos
Bessie
B
Hunter
Eduardo
E
Chávez
Oscar
O
Brunser
Magdalena
M
Araya
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000302:isolation & purification; D015415:Biomarkers / Q000097:blood; D002446:Celiac Disease / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology*; D004032:Diet; D005260:Female; D005983:Glutens / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007515:Islets of Langerhans / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors
D001323:Autoantibodies; D015415:Biomarkers; C024211:islet cell antibody; D005983:Glutens