title: Screening for associated autoimmunity in children and adolescents with type 1 diabetes mellitus (T1DM).
abstract: 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.
authors.affiliation: Diabetic Clinic, B' Pediatric Department, University of Athens, 'P. & A. Kyriakou' Children's Hospital, Athens, Greece. kkarav@yahoo.gr
authors.forename: Kyriaki
authors.initials: K
authors.lastname: Karavanaki
authors.forename: Kostas
authors.initials: K
authors.lastname: Kakleas
authors.forename: Evangelia
authors.initials: E
authors.lastname: Paschali
authors.forename: Nikos
authors.initials: N
authors.lastname: Kefalas
authors.forename: Ilias
authors.initials: I
authors.lastname: Konstantopoulos
authors.forename: Vassilis
authors.initials: V
authors.lastname: Petrou
authors.forename: Maria
authors.initials: M
authors.lastname: Kanariou
authors.forename: Christina
authors.initials: C
authors.lastname: Karayianni
mesh_terms: 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
chemical_list: D001323:Autoantibodies; D005968:Glutamate Decarboxylase