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OBJECTIVE - To evaluate the prevalence of β-cell autoimmunity and the usefulness of a type 1 diabetes screening in patients with celiac disease.
RESEARCH DESIGN AND METHODS - We measured GAD antibodies (GADAs), insulinoma-associated protein 2 antigens (IA-2As), and insulin autoantibodies (IAAs) in 188 young Italian patients with celiac disease (66 male [35.1%]). Mean age at celiac disease diagnosis was 5.4 years (0.5-17.1), and mean celiac disease duration was 4.2 years (0-28.8). Celiac disease was diagnosed by jejunal biopsy after positivity for endomysial and tissue transglutaminase antibody was confirmed.
RESULTS - GADAs were positive in seven patients (3.7%), and IA-2As were positive in two patients. IAAs were negative in all cases. Metabolic evaluation was normal, and no patients developed diabetes during follow-up. There was no significant association among β-cell autoimmunity and sex, age, pubertal stage, family history, or coexistence of other autoimmune disorders; compliance to a gluten-free diet was confirmed.
CONCLUSIONS - Our results showed a low prevalence of β-cell autoimmunity and do not support a precocious screening for β-cell autoimmunity in young celiac disease patients.
Diabetes Care 32:254-256, 2009
Celiac disease, whose prevalence in the general Western population is about 1%, is associated with other autoimmune disorders (1). Type 1 diabetes and celiac disease share a prodromic period, with autoantibodies to islet or gut antigens. Antibodies to GAD (GADAs), to insulinoma-associated protein 2 antigen (IA-2A), and anti-insulin (insulin autoantibody [IAA]) are used for type 1 diabetes screening; antiendomysial antibodies (EMAs) and endomysial tissue transglutaminase antibodies (tTGAs) are recommended for celiac disease screening (2,3). Few reports investigated β-cell autoimmunity in celiac disease patients (4,5). We evaluated the frequency of β-cell autoimmunity and the usefulness of type 1 diabetes screening in young celiac disease patients.
RESEARCH DESIGN AND METHODS - We measured ß-cell autoantibodies in 188 Italian patients with celiac disease diagnosed by jejunal biopsy according to Marsh staging criteria after confirmation of EMA and tTGA positivity and presentation of various degrees of symptoms. Gluten-free diet (GFD) compliance was evaluated by means of EMA and tTGA.
IgA tTGA was detected using enzyme-linked immunosorbent assay, and IgA EMA by indirect immunofluorescence. All samples were analyzed for GADA, IA-2A, and IAA with radiobinding assays (6). Personal and family histories for other autoimmune disorders were recorded.
Comparison of...