Screening detected celiac disease in children with type 1 diabetes mellitus: effect on the clinical course (a case control study).
OBJECTIVE
To investigate clinical and metabolic characteristics of diabetic children with screening detected celiac disease in a multicenter case-control study.


METHODS



METHODS
98 diabetic patients were diagnosed as having silent celiac disease by screening with endomysial antibodies and subsequent biopsy.


METHODS
two controls in the same center were chosen, (stratified by age and age-at-diabetes onset) who were negative for endomysial antibodies (n = 195). Height, weight, HbA1c, insulin dosage and acute complications were documented for at least 1 year of follow up.


RESULTS
Mean age of diabetes manifestation was 6.5 +/- 4.1 years and diagnosis of celiac disease was made at 10.0 +/- 5.4 years. Biopsy showed total or subtotal mucosal atrophy in 74 patients. The mean observation period after the diagnosis of celiac disease was 3.3 +/- 1.9 years. Mean HbA1c levels were similar between cases and controls (8.63% +/- 1.45% versus 8.50% +/- 1.39%; P = 0.35). There was also no difference in the frequency of severe hypoglycemia, ketoacidosis and the applied insulin dosage (P = 0.45). Body mass index-standard deviation score at celiac disease diagnosis (0.57 +/- 1.24 versus 0.52 +/- 1.07) and height-standard deviation score (0.14 +/- 1.13 versus 0.30 +/- 0.95) did not differ between cases and controls. After diagnosis of celiac disease, weight gain was diminished in boys with celiac disease compared with their controls (P < 0.05). Female cases also had a lower body mass index than female controls (P = 0.067).


CONCLUSIONS
In a cohort of diabetic children, silent celiac disease had no obvious effect on metabolic control but negatively influenced weight gain.
Rami
Birgit
B
Department of Pediatrics, Medical University Vienna, Vienna, Austria.
Sumnik
Zdenek
Z
Schober
Edith
E
Waldhör
Thomas
T
Battelino
Tadej
T
Bratanic
Nina
N
Kürti
Kalman
K
Lebl
Jan
J
Limbert
Catarina
C
Madacsy
Laszlo
L
Odink
Roetloef J H
RJ
Paskova
Magdalena
M
Soltesz
Gyula
G
D001323:Autoantibodies / Q000097:blood; D016022:Case-Control Studies; D002446:Celiac Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D002648:Child; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008403:Mass Screening; D015995:Prevalence; D012737:Sex Factors; D015430:Weight Gain
D001323:Autoantibodies; D006442:Glycated Hemoglobin