Screening for associated autoimmunity in children and adolescents with type 1 diabetes mellitus (T1DM).
OBJECTIVE
Type 1 diabetes (T1DM) is associated with autoimmune thyroid, celiac, autoimmune gastric and Addison's disease. Our aim was to investigate the prevalence of associated autoantibodies in relation to the demographic and beta-cell autoantibody status (anti-GAD).


METHODS
Antibodies against thyroid peroxidase (anti-TPO), thyroglobulin (anti-Tg), tissue transglutaminase (anti-tTG IgA), parietal cells (APCA) and adrenal tissue (AAA) were measured in 144 children with T1DM with a mean +/- SD age of 12.3 +/- 4.6 years and a diabetes duration of 4.6 +/- 3.8 years.


RESULTS
The prevalence of antibody positivity among our patients was: anti-GAD 53.2%, anti-thyroid (anti-TPO 17.4%, anti-Tg 11.1%); anti-tTG IgA 7.6%, APCA 4.0%, and AAA 0%. Among the children with positive anti-thyroid antibodies, 60% developed autoimmune thyroiditis, while among those anti-tTG IgA positive, 62.5% developed biopsy-confirmed celiac disease. Female gender was more frequent among anti-tTG IgA-positive patients (OR 4.47, p = 0.068), while increasing age was associated with anti-Tg positivity (OR 22.9, p = 0.041). The presence of anti-thyroid antibodies was associated with the presence of anti-GAD (OR 1.45, p = 0.01) and parietal cell antibodies (OR 4.98, p = 0.09).


CONCLUSIONS
Among T1DM patients, the prevalence rates of anti-thyroid and parietal cell antibodies increased with age and diabetes duration. As the presence of anti-GAD was associated with gastric and thyroid autoimmunity, it could serve as marker for the development of additional autoimmunity in adolescents with diabetes.
Karavanaki
Kyriaki
K
Diabetic Clinic, B' Pediatric Department, University of Athens, 'P. & A. Kyriakou' Children's Hospital, Athens, Greece. kkarav@yahoo.gr
Kakleas
Kostas
K
Paschali
Evangelia
E
Kefalas
Nikos
N
Konstantopoulos
Ilias
I
Petrou
Vassilis
V
Kanariou
Maria
M
Karayianni
Christina
C
D000293:Adolescent; D001323:Autoantibodies / Q000276:immunology*; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000276:immunology; D015551:Autoimmunity / Q000276:immunology*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000276:immunology*; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology; D006801:Humans; D050417:Insulin-Secreting Cells / Q000276:immunology; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D015995:Prevalence; D013270:Stomach / Q000276:immunology; D013961:Thyroid Gland / Q000276:immunology; D013967:Thyroiditis, Autoimmune / Q000276:immunology
D001323:Autoantibodies; D005968:Glutamate Decarboxylase