High prevalence of celiac disease in Mexican Mestizo adults with type 1 diabetes mellitus.
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.
Remes-Troche
José María
JM
Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Rios-Vaca
Aurelio
A
Ramírez-Iglesias
María Teresa
MT
Rubio-Tapia
Alberto
A
Andrade-Zarate
Vicente
V
Rodríguez-Vallejo
Fanny
F
López-Maldonado
Francisco
F
Gomez-Perez
Francisco Javier
FJ
Uscanga
Luis F
LF
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
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