Long-standing type 1 diabetes: patients with adult-onset develop celiac-specific immunoreactivity more frequently than patients with childhood-onset diabetes, in a disease duration-dependent manner.
To assess the frequency of celiac-associated humoral autoimmunity in patients with long-standing childhood- and adult-onset type 1 diabetes (LDM1) and whether it occurs more frequently as the disease progresses. IgA-/IgG-anti-tissue transglutaminase (IgA-tTG and IgG-tTG) and IgA-/IgG-deamidated gliadin (DGP) antibodies were analyzed in 277 LDM1 sera (120 females; disease duration 19.3 ± 12.3 years, range 5.0-54.0 years). Of the 277 patients, 147 were childhood-onset LDM1 ((CH)LDM1) and 130 adult-onset LDM1 ((AD)LDM1); 6.1 % LDM1 sera were tTG- and/or DGP-antibody-positive, with a lower frequency among (CH)LDM1 as compared with (AD)LDM1 patients (3.4 vs 9.2 %, p = 0.048). Celiac-associated immunoreactivity was significantly more frequent in LDM1 with >15 years of disease duration (9.4 vs 2.9 % in those with ≤15 years, p = 0.042) and among them in (AD)LDM1 (14.7 vs 4.2 % (CH)LDM1, p = 0.043). Celiac disease humoral immunoreactivity should be screened not only at diabetes onset, but also in long-standing patients, especially adults with disease duration >15 years.
Department of Internal Medicine, Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
Claudio
C
Tiberti
Francesca
F
Panimolle
Margherita
M
Bonamico
Tiziana
T
Filardi
Lucia
L
Pallotta
Raffaella
R
Nenna
Stefano
S
Pontone
Francesco
F
Dotta
Giuseppe
G
Pugliese
Andrea
A
Lenzi
Stefano
S
Balducci
Susanna
S
Morano
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001323:Autoantibodies / Q000097:blood / Q000276:immunology; D002446:Celiac Disease / Q000097:blood / Q000209:etiology / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000276:immunology; D005260:Female; D019204:GTP-Binding Proteins / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood / Q000276:immunology; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D008297:Male; D008875:Middle Aged; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases / Q000276:immunology; D055815:Young Adult
D001323:Autoantibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins