Screening detected celiac disease in children with type 1 diabetes mellitus: effect on the clinical course (a case control study)

J Pediatr Gastroenterol Nutr. 2005 Sep;41(3):317-21. doi: 10.1097/01.mpg.0000174846.67797.87.

Abstract

Objective: To investigate clinical and metabolic characteristics of diabetic children with screening detected celiac disease in a multicenter case-control study.

Cases: 98 diabetic patients were diagnosed as having silent celiac disease by screening with endomysial antibodies and subsequent biopsy.

Controls: two controls in the same center were chosen, (stratified by age and age-at-diabetes onset) who were negative for endomysial antibodies (n = 195). Height, weight, HbA1c, insulin dosage and acute complications were documented for at least 1 year of follow up.

Results: Mean age of diabetes manifestation was 6.5 +/- 4.1 years and diagnosis of celiac disease was made at 10.0 +/- 5.4 years. Biopsy showed total or subtotal mucosal atrophy in 74 patients. The mean observation period after the diagnosis of celiac disease was 3.3 +/- 1.9 years. Mean HbA1c levels were similar between cases and controls (8.63% +/- 1.45% versus 8.50% +/- 1.39%; P = 0.35). There was also no difference in the frequency of severe hypoglycemia, ketoacidosis and the applied insulin dosage (P = 0.45). Body mass index-standard deviation score at celiac disease diagnosis (0.57 +/- 1.24 versus 0.52 +/- 1.07) and height-standard deviation score (0.14 +/- 1.13 versus 0.30 +/- 0.95) did not differ between cases and controls. After diagnosis of celiac disease, weight gain was diminished in boys with celiac disease compared with their controls (P < 0.05). Female cases also had a lower body mass index than female controls (P = 0.067).

Conclusion: In a cohort of diabetic children, silent celiac disease had no obvious effect on metabolic control but negatively influenced weight gain.

Publication types

  • Multicenter Study

MeSH terms

  • Autoantibodies / blood
  • Case-Control Studies
  • Celiac Disease / diagnosis*
  • Celiac Disease / epidemiology
  • Celiac Disease / pathology
  • Child
  • Cohort Studies
  • Diabetes Mellitus, Type 1 / complications*
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin A / analysis
  • Humans
  • Male
  • Mass Screening
  • Prevalence
  • Sex Factors
  • Weight Gain

Substances

  • Autoantibodies
  • Glycated Hemoglobin A