The prevalence and risk factors for coeliac disease among children and adolescents with type 1 diabetes mellitus.
OBJECTIVE
Our aim was to determine in children with T1DM the prevalence of positive antibodies against tissue transglutaminase (anti-tTG IgA) as indices of coeliac disease (CD), as well as its clinical presentation, its determinants and its association with thyroid (anti-TG, anti-TPO) and pancreatic b-cell autoimmunity (anti-GAD).


METHODS
The study included 105 children and adolescents with T1DM, aged (mean±SD) 12.44±4.76 years, with a T1DM duration of 4.41±3.70 years.


RESULTS
Fifty of our patients (47.6%) were positive for anti-GAD, 9/105 (8.6%) for anti-tTG IgA and 21/105(20%) for anti-thyroid antibodies. The anti-tTG IgA (+) children, in comparison with the rest of the study population, were of younger age (9.31 vs. 12.74 years, p=0.038), shorter diabetes duration (2.16 vs. 4.62 years, p=0.056) and had mild growth impairment (height SDS: -0.55 vs. +0.20, p=0.055). Univariate logistic regression analysis revealed that the presence of anti-tTG IgA (+) was associated with younger age and shorter T1DM duration. Only 5/9 (55.6%) children with high titres of anti-tTG IgA developed mild gastrointestinal symptoms or growth retardation and had histological findings typical of CD.


CONCLUSIONS
The prevalence of anti-tTG IgA positivity among T1DM children was 8.6% and its occurrence was associated with younger age and short diabetes duration. Since CD presents in T1DM patients asymptomatically or with non-specific symptoms, periodic autoantibody screening is necessary for its early diagnosis.
Kakleas
Kostas
K
Second University Department of Pediatrics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.
Karayianni
Christina
C
Critselis
Elena
E
Papathanasiou
Asteroula
A
Petrou
Vassilis
V
Fotinou
Aspasia
A
Karavanaki
Kyriaki
K
D000293:Adolescent; D017668:Age of Onset; D001323:Autoantibodies / Q000276:immunology*; D015551:Autoimmunity / Q000276:immunology*; D015992:Body Mass Index; D002446:Celiac Disease / Q000150:complications / Q000453:epidemiology* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology* / Q000276:immunology; D005968:Glutamate Decarboxylase / Q000276:immunology; D006130:Growth Disorders / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D050417:Insulin-Secreting Cells / Q000276:immunology*; D007453:Iodide Peroxidase / Q000276:immunology; D015995:Prevalence; D012307:Risk Factors; D013954:Thyroglobulin / Q000276:immunology
D001323:Autoantibodies; D013954:Thyroglobulin; D007453:Iodide Peroxidase; D005968:Glutamate Decarboxylase