The Prevalence of Celiac Disease in Patients with Diabetes Mellitus—The Prevalence of Celiac Disease

Abstract

AIM: To determine the prevalence of celiac disease related autoantibodies in patients with type 1 and 2 diabetes mellitus (DM), and to compare these results with the general population. METHODS: In total, 137 consecutive patients with type 1 DM, 172 with type 2 DM and 113 age-sex matched control subjects were included into the study. Antigliadin-autoantibodies (AGA) IgG and IgA, and endomysial-antibodies(EMA) IgG and IgA antibodies were determined. Patients who were positive for one or more were offered a gastroduodenoscopic examination. RESULTS: AGA IgG positivity was detected in 38.7% (53/137) patients with type 1 DM in 26.2% (45/172) patients with type 2 DM and in 16.8% (19/113) control subjects (significant differences). AGA IgA positivity was detected in 24.8% (34/137) patients with type 1 DM, in 9.3% (16/172) patients with type 2 DM and in 3.5% (4/113) control subjects (significant differences). EMA IgG positivity was detected in 10.2% (14/137) patients with type 1 DM in 0.6% (1/176) patients with type 2 DM and 0.9% (1/113) control subjects (significant differences). EMA IgA positivity was detected in 11.7% (16/137) patients with type 1 DM in 0.6% (1/172) patients with type 2 DM and in none of control subjects. EMA IgA positivity was sig- nificantly higher in patients with type 1 DM as compared with patients with type 2 DM and controls. CONCLUSION: High prevalence of celiac disease at the diagnosis of type 1 DM is observed. Serological markers are useful for identifying celiac disease patients with type 1 DM.

Share and Cite:

D. Gökalp, S. Arıkan, M. Yakut, Y. Tüzün, A. Tuzcu, M. Bahçeci, S. Arikan and İ. Soykan, "The Prevalence of Celiac Disease in Patients with Diabetes Mellitus—The Prevalence of Celiac Disease," International Journal of Clinical Medicine, Vol. 2 No. 3, 2011, pp. 201-205. doi: 10.4236/ijcm.2011.23033.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Farrell RJ, Kelly CP. Celiac sprue and refractory sprue.Fordtran and Sleisenger Gastrointestinal and liver disease. Vol. 2 pp. 2277-2306
[2] Dirks M. Preventive health care, 2004 update: screening persons with insulin-dependent diabetes mellitus with se- rology for celiac disease: systematic review & recom- mendations. CMAJ.
[3] Cruz JC, Rode EC , Gomez LS, et al. Celiac disease as- sociated antibodies in persons with latent autoimmune diabetes of adult and type 2 diabetes. Autoimmunity 2007 Mar; 40(2): 103-7
[4] Catassi C, Fabiani E, R?tsch IM, Coppa GV, Giorgi PL, et al. The coeliac iceberg in Italy. A multicentre antigli- adin antibodies screening for coeliac disease in school- age subjects. Acta Paediatr Suppl. 1996 May; 412: 29-35
[5] De Vitis I, Ghirlanda G, Gasbarrini G. Prevalence of coeliac disease in type I diabetes: a multicentre study. Acta Paediatr Suppl. 1996;412:56-57
[6] Dieterich W, Ehnis T, Bauer M, et al. Identification of tissue transglutaminase as the autoantigen of celiac dis- ease. Nat Med. 1997; 3: 797-801
[7] Logan RF, Rifkind EA, Turner ID, Ferguson A. Mortality in celiac disease. Gastroenterology. 1989; 97: 265-271
[8] Lerner A, Lebenthal E. The controversy of the use of anti-gluten antibody (AGA) as a diagnostic tool in celiac disease. J Pediatr Gastroenterol Nutr. 1991; 12: 407-409
[9] Ascher H, Hahn-Zoric M, Hansson L?, Kilander AF, Nilsson L?, Tlaskalova′ H. Value of serologic markers for clinical diagnosis and population studies of coeliac disease. Scand J Gastroenterol. 1996; 31: 61-67
[10] Bürgin-Wolff A, Gaze H, Hadziselimovic F, et al. An- tigliadin and antiendomysium antibody determination for coeliac disease. Arch Dis Child. 1991; 66: 941-947
[11] Farrell RJ, Kelly CP. Current concepts: celiac sprue . N Engl J Med 2002; 346:180-188.
[12] Lorini R, Scaramuzza A, Vitali L, et el. Clinical aspects of coeliac disease in children with insulin-dependent dia- betes mellitus. J Pediatr Endocrinol Metab. 1996; 9: 101-111
[13] Markku M, Pekka C. Celiac disease. Lancet 1997; 349: 1755-9.
[14] Corazza GR, Biagi F, Andreani ML, et al. Screening test for celiac disease. Lancet 1997; 349: 325-6.
[15] Corrao G, Corazza GR, Andreani ML, et al. Serological screening of celiac disease: Choosing the optimal pro- cedure according to various prevalence values. Gut 1994; 35: 771-5.
[16] Sulkanen S, Halttunen T, Laurila K, et al. Tissue trans- glutaminase autoantibody enzyme-linked imunosorbent assay in detecting celiac disease. Gastroenterology 1998; 115: 132208.
[17] Valdimarsson T, Franzen L, Grodzinsky E et al. Is small bowel biopsy necessary in adults with suspected celiac disease and IgA anti-endomysium antibodies? 100% positive predictive value for celiac disease in adults. Dig Dis Sci 1996; 41(1): 83087.
[18] Rostom A, Dube C, Cranney A et al. Celiac disease. Evi- dence Report/Technology Assessment No. 104. AHRQ Publication No. 04-E029-2. Rockville, MD: Agency for Healthcare Research and Quality; 2004.
[19] Sategna-Guidetti C, Pulitano R, Grosso S & Ferfoglia G. Serum IgA antiendomysium antibody titers as a marker of intestinal involvement and diet compliance in adult celiac sprue. J Clin Gastroenterol 1993; 17(2):123-127.
[20] Talal AH, Murray JA, Goeken JA, et al. Celiac disease in adult population with insulin-dependent diabetes mellitus: Use of endomysial antibody testing. Am J Gastroenterol 1997; 92: 1280-4.
[21] Rensch MJ, Merenich JA, Lieberman M, et al. Glu- ten-sensitive enteropathy in patients with insulin-dependent diabetes mellitus. Ann Intern Med 1996; 124: 564-7.
[22] Carlsson AK, Axelsson IE, Borulf SK, et al. Prevalence of IgA-antiendomysium and IgA-antigliadin autoantibodies at diagnosis of insulin-dependent diabetes mellitus in Swedish children and adolescents. Pediatrics 1999; 103: 1248-52.
[23] Aygun C, Uraz S, Damci T, Osar Z, Yumuk V, Akdenizli E, Ilkova H. Celiac disease in an adult Turkish population with type 1 diabetes mellitus. Dig Dis Sci. 2005 Aug; 50(8): 1462-6.
[24] Hummel M, Bonifacio E, Stern M, Dittler J, Schimmel A, Ziegler AG. Development of celiac disease-associated antibodies in offspring of parents with type I diabetes. Diabetologia. 2000; 43: 1005-1011
[25] Holmes GKT. Long-term health risks for unrecognized coeliac patients. In: Auricchio S, Visakorpi JK, eds. Common Food Intolerance. I. Epidemiology of Coeliac Disease. Basel, Switzerland: Karger; 1992:105-118
[26] West J, Logan RF, Smith CJ, Hubbard RB, Card TR. Malignancy and mortality in people with coeliac disease: population based cohort study. BMJ 2004; 329: 716-9.

Copyright © 2021 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.