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Celiac autoantibody positivity in relation to clinical characteristics in children with type 1 diabetes
Khalid Siddiqui1,2, Shaik Sarfaraz Nawaz2, Nada Hareb Al Sumri1,3
1University Diabetes Center, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia.
Insights
Children with type 1 diabetes have a high risk of celiac disease (CD). Routine screening for CD autoantibodies is recommended in this population, with further endoscopic evaluation needed for confirmation.
Area of Science:
- Pediatric Endocrinology
- Autoimmune Disorders
- Gastroenterology
Background:
- Type 1 diabetes (T1D) is an autoimmune condition.
- Individuals with T1D have an increased prevalence of celiac disease (CD).
- Early detection of CD in T1D is crucial for managing complications.
Purpose of the Study:
- To assess celiac autoantibody status in children with T1D.
- To compare clinical characteristics between children with T1D with and without CD autoantibodies.
- To evaluate the utility of serological screening for CD in pediatric T1D.
Main Methods:
- A cross-sectional study involving 240 children diagnosed with T1D.
- Serological screening for anti-endomysial and anti-tissue transglutaminase antibodies.
- Evaluation of blood glucose, HbA1c, and various biochemical markers including hemoglobin, calcium, Vitamin D, and liver enzymes (ALT, ALP, AST, GGT).
Main Results:
- 66 out of 240 children (27.5%) with T1D were positive for CD autoantibodies.
- Only 35 children (14.6%) showed serological evidence of CD.
- The study identified a significant proportion of children with T1D who are at risk for CD based on antibody positivity.
Conclusions:
- Celiac disease is frequently associated with type 1 diabetes in children.
- Routine serological screening for CD autoantibodies is warranted in all children with T1D.
- Prospective follow-up with endoscopic evaluation is necessary to confirm CD diagnoses in antibody-positive T1D patients.
Background:
Type 1 diabetes is an autoimmune disorder with a high risk of celiac disease (CD).
Aim:
This study aimed to determine the celiac autoantibody status and the clinical characteristics among children with type 1 diabetes and autoantibody positivity for CD compared to those without serological evidence of CD.
Materials And Methods:
In this cross-sectional study, 240 children with type 1 diabetes underwent serological screening CD. Blood glucose, glycated hemoglobin (HbA1c), hemoglobin, calcium, phosphorous, Vitamin D, alanine aminotransferase (ALT), alkaline phosphatase (ALP), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) were evaluated. The participants were screened for human anti-endomysial antibody and human anti-tissue transglutaminase antibody.
Results:
Of the 240 children with type 1 diabetes, 66 children were antibody positive for either anti-endomysial or anti-tissue transglutaminase or both autoantibodies for CD. There were 36 (54.5%) female and 30 (45.5%) male children with the mean age of 15.5±2.1 years. The mean duration of diabetes was 6.8±3.8 years. Only 35 (14.6%) children were found to have serological evidence of CD.
Conclusion:
CD is associated with type 1 diabetes. Serological screening for CD autoantibody should be performed routinely in children with type 1 diabetes. There is discrepancy in screening CD with antibodies, so a prospective follow-up of this cohort is needed for endoscopic evaluation and histopathological examination of intestinal biopsy to confirm CD in this population.
Relevance For Patients:
Anti-endomysial and anti-tissue transglutaminase autoantibodies should be included for screening CD among children with type 1 diabetes. Patients should undergo an endoscopy to confirm a diagnosis of CD.
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