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Published on: May 6, 2013
Additional autoimmune disease found in 33% of patients at type 1 diabetes onset
Taylor M Triolo1, Taylor K Armstrong, Kim McFann
1Barbara Davis Center for Childhood Diabetes, Aurora, Colorado, USA. taylor.triolo@ucdenver.edu
Insights
Many children with type 1 diabetes have other autoimmune conditions. Screening for organ-specific autoantibodies at diagnosis can identify these comorbidities early, preventing complications.
Area of Science:
- Endocrinology
- Immunology
- Pediatrics
Background:
- Type 1 diabetes (T1D) is an autoimmune disease.
- Nonislet autoantibodies are associated with other autoimmune conditions.
- Early detection of comorbidities in T1D is crucial for management.
Purpose of the Study:
- To determine the prevalence of nonislet, organ-specific autoantibodies in children diagnosed with T1D.
- To assess the frequency of comorbid autoimmune diseases in this population.
Main Methods:
- A cohort of 491 children diagnosed with T1D were screened.
- Screening included tests for autoimmune thyroid disease (thyroid peroxidase autoantibodies [TPOAb]), celiac disease (tissue transglutaminase autoantibodies [TTGAb]), and Addison disease (21-hydroxylase autoantibodies [21OHAb]).
Main Results:
- 161 out of 491 children (32.8%) had at least one nonislet autoantibody.
- Prevalence of specific autoantibodies: TPOAb (24.8%), TTGAb (11.6%), 21OHAb (1.0%).
- Comorbidities detected: autoimmune thyroid disease (12.3% of TPOAb+), celiac disease (24.6% of TTGAb+), Addison disease (1 of 21OHAb+).
Conclusions:
- A significant proportion of children with T1D exhibit nonislet autoantibodies.
- These autoantibodies are linked to a higher prevalence of comorbid autoimmune disorders.
- Screening for these autoantibodies at T1D diagnosis can facilitate early detection and management of associated conditions.
Objective:
We sought to define the prevalence of nonislet, organ-specific autoantibodies at diagnosis of type 1 diabetes and to determine the prevalence of comorbid autoimmune diseases.
Research Design And Methods:
Children (n = 491) diagnosed with type 1 diabetes at the Barbara Davis Center for Childhood Diabetes were screened for autoimmune thyroid disease (thyroid peroxidase autoantibodies [TPOAb]), celiac disease (tissue transglutaminase autoantibodies [TTGAb]), and Addison disease (21-hydroxylase autoantibodies [21OHAb]).
Results:
Of the 491 children, 161 had at least one nonislet autoantibody, and of these, 122 (24.8%) were positive for TPOAb, and 15 of the 122 (12.3%) had autoimmune thyroid disease. There were 57 (11.6%) who were positive for TTGAb, of whom 14 (24.6%) had celiac disease. Five (1.0%) were positive for 21OHAb, of whom one had Addison disease.
Conclusions:
Many autoantibody-positive subjects present with additional autoimmune disorders. Detection of these autoantibodies at type 1 diabetes onset may prevent complications associated with delayed diagnosis of these disorders.
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