Impact of celiac autoimmunity on children with type 1 diabetes

J Pediatr. 2007 May;150(5):461-6. doi: 10.1016/j.jpeds.2006.12.046.

Abstract

Objective: Children with type 1 diabetes (T1DM) are at increased risk for celiac disease (CD); however, the benefits of screening for IgA tissue transglutaminase autoantibodies (TG), a marker for CD, are unclear.

Study design: We compared 71 screening-identified TG+ with 63 matched TG- children with TIDM. Growth, bone density, and diabetes control measures were obtained.

Results: The group was 10 +/- 3 years of age, 46% male, with TIDM for 4 +/- 3 years. Z scores for weight (0.3 +/- 1 vs 0.7 +/- 0.8, P = .024), body mass index (BMI) (0.3 +/- 0.9 vs 0.8 +/- -0.8, P = .005), and midarm circumference (0.3 +/- 1.1 vs 0.6 +/- 0.9, P = .031) were lower in the TG+ group. Bone mineral density and diabetes control measures were similar. When limiting the analysis to the 35 TG+ subjects with biopsy changes of CD, the BMI Z score was lower than the control group (0.4 +/- 0.9 vs 0.7 +/- 0.7, P = .05).

Conclusions: In children with TIDM, screening-identified evidence of CD is associated with altered body composition, but not bone mineral density or diabetes control. Further study is needed to determine the benefit of early diagnosis and treatment of CD in TIDM children.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Autoantibodies / blood*
  • Autoimmunity
  • Celiac Disease / blood*
  • Celiac Disease / complications
  • Celiac Disease / diagnosis
  • Celiac Disease / immunology*
  • Child
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / complications*
  • Female
  • Humans
  • Male
  • Transglutaminases / immunology

Substances

  • Autoantibodies
  • Transglutaminases