High prevalence of celiac disease in Mexican Mestizo adults with type 1 diabetes mellitus

J Clin Gastroenterol. May-Jun 2008;42(5):460-5. doi: 10.1097/MCG.0b013e318046ea86.

Abstract

Background and aims: Recent studies have shown that celiac disease (CD) could affect 0.5% to 3% of the general population, including Mexican Mestizos, which represents a complex mixture of genetics, and constitutes the core of Mexican and Latin American populations. However, the association between CD and other conditions, specifically type-1 diabetes mellitus, in this population remains unknown. Thus, our aim was to determine the prevalence of both serologic and biopsy proven CD in Mexican Mestizo adults with type-1 diabetes.

Methods: Over a 6-month period, serum samples obtained from consecutive Mexican Mestizo adult patients (age >or=18 y) with type-1 diabetes were tested with a new generation human recombinant protein based IgA tissue transglutaminase enzyme-linked immunosorbent assay commercial kit. All patients with positive serologic test results underwent upper gastrointestinal endoscopy and small intestinal biopsies to confirm CD.

Results: Eighty-four type-1 diabetic patients were included (62 women, mean age 28.9+/-9 y). Overall, 9 patients (9/84) were positive for IgA tissue transglutaminase with a point prevalence of 10.7% (95% CI, 4%-17%). Seven patients agreed to undergo endoscopy. Five subjects had biopsy-proven CD (5.9%, 95% CI, 1.9%-13.3%). One patient had chronic diarrhea and other abdominal bloating; whereas the remaining 3 were asymptomatic. CD associated type-1 diabetic patients tended to have higher hemoglobin A1c levels (P=0.07), reflecting poor glycemic control.

Conclusions: As in other populations, we demonstrated a high prevalence of biopsy-proven CD (5.9%) among Mexican Mestizo patients with type-1 diabetes. Clinicians should be aware of this common association in this ethnic group.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Antibodies, Anti-Idiotypic / immunology
  • Benzamides
  • Biopsy
  • Celiac Disease / complications
  • Celiac Disease / diagnosis
  • Celiac Disease / ethnology*
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications*
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • GTP-Binding Proteins
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Immunoglobulin A / immunology
  • Intestine, Small / immunology
  • Intestine, Small / pathology
  • Male
  • Mexico / epidemiology
  • Prevalence
  • Prospective Studies
  • Transglutaminases / immunology

Substances

  • Antibodies, Anti-Idiotypic
  • Benzamides
  • Glycated Hemoglobin A
  • Immunoglobulin A
  • isoxaben
  • transglutaminase 2
  • Transglutaminases
  • GTP-Binding Proteins