title: High prevalence of celiac disease in Mexican Mestizo adults with type 1 diabetes mellitus.
abstract: OBJECTIVE
  Recent studies have shown that celiac disease (CD) could affect 0.5% to 3% of the general population, including Mexican Mestizos, which represents a complex mixture of genetics, and constitutes the core of Mexican and Latin American populations. However, the association between CD and other conditions, specifically type-1 diabetes mellitus, in this population remains unknown. Thus, our aim was to determine the prevalence of both serologic and biopsy proven CD in Mexican Mestizo adults with type-1 diabetes.
  
  
  METHODS
  Over a 6-month period, serum samples obtained from consecutive Mexican Mestizo adult patients (age >or=18 y) with type-1 diabetes were tested with a new generation human recombinant protein based IgA tissue transglutaminase enzyme-linked immunosorbent assay commercial kit. All patients with positive serologic test results underwent upper gastrointestinal endoscopy and small intestinal biopsies to confirm CD.
  
  
  RESULTS
  Eighty-four type-1 diabetic patients were included (62 women, mean age 28.9+/-9 y). Overall, 9 patients (9/84) were positive for IgA tissue transglutaminase with a point prevalence of 10.7% (95% CI, 4%-17%). Seven patients agreed to undergo endoscopy. Five subjects had biopsy-proven CD (5.9%, 95% CI, 1.9%-13.3%). One patient had chronic diarrhea and other abdominal bloating; whereas the remaining 3 were asymptomatic. CD associated type-1 diabetic patients tended to have higher hemoglobin A1c levels (P=0.07), reflecting poor glycemic control.
  
  
  CONCLUSIONS
  As in other populations, we demonstrated a high prevalence of biopsy-proven CD (5.9%) among Mexican Mestizo patients with type-1 diabetes. Clinicians should be aware of this common association in this ethnic group.
authors.affiliation: Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
authors.forename: José María
authors.initials: JM
authors.lastname: Remes-Troche
authors.forename: Aurelio
authors.initials: A
authors.lastname: Rios-Vaca
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Ramírez-Iglesias
authors.forename: Alberto
authors.initials: A
authors.lastname: Rubio-Tapia
authors.forename: Vicente
authors.initials: V
authors.lastname: Andrade-Zarate
authors.forename: Fanny
authors.initials: F
authors.lastname: Rodríguez-Vallejo
authors.forename: Francisco
authors.initials: F
authors.lastname: López-Maldonado
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Gomez-Perez
authors.forename: Luis F
authors.initials: LF
authors.lastname: Uscanga
mesh_terms: D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology; D001549:Benzamides; D001706:Biopsy; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis / Q000208:ethnology*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D019204:GTP-Binding Proteins; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D007421:Intestine, Small / Q000276:immunology / Q000473:pathology; D008297:Male; D008800:Mexico / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases / Q000276:immunology
chemical_list: D000888:Antibodies, Anti-Idiotypic; D001549:Benzamides; D019204:GTP-Binding Proteins; D006442:Glycated Hemoglobin; D007070:Immunoglobulin A; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; C057467:isoxaben