Development of autoimmunity to transglutaminase C in children of patients with type 1 diabetes: relationship to islet autoantibodies and infant feeding

Abstract

Aims/hypothesis Coeliac disease and transglutaminase antibodies are common in patients with type 1 diabetes and their relatives. We investigated the development of transglutaminase antibodies and analysed potential risk factors for coeliac disease autoimmunity in first-degree relatives of patients with type 1 diabetes. Methods The study was conducted by prospective observational follow-up from birth of 1,511 children at increased risk of type 1 diabetes or coeliac disease born in Germany between 1989 and 2000. Mean follow-up was to age 7.6 years. Children were tested for transglutaminase and islet autoantibodies. Children were classified as transglutaminase antibody-positive if antibodies were detected by both ELISA and radiobinding assays. Results The risk of developing transglutaminase antibodies was 4.9% by age 8 years (n=63; 95% CI, 3.7-6.1%). Transglutaminase antibodies developed at an older age than islet autoantibodies (median age, 4.9 vs 2.3 years; p<0.005), and only three children developed both transglutaminase antibodies and islet autoantibodies. Multivariate analysis indicated an increased risk of transglutaminase antibodies in children with the HLA-DRB1*03 allele (hazard ratio for heterozygous DR3, 5.5; 95% CI, 2.9-10.2; hazard ratio for homozygous DR3, 16.2; 95% CI, 6.7-39; p<0.0001) and in children with impaired uterine growth (birth weight ≤ 1st percentile, hazard ratio, 3

Serologic Screening of Celiac Disease in Patients With Type 1 Diabetes

“…One possibility is that the children with CD-associated antibodies seroconverted to positivity for diabetes-associated autoantibodies earlier than those who did not have CD-associated antibodies, so that celiac disease developed earlier than diabetes [24,25]. Whereas, results differ clearly in another study, in which diabetes-associated autoantibodies developed earlier than celiac disease-associated antibodies [26] and the diagnosis of T1DM usually precedes CD [23]. In our study, the patients suffering from both CD and diabetes were younger than the patients affected by diabetes only, which may be explained by the fact of that CD-associated antibodies seroconverted to positivity for diabetes-associated autoantibodies earlier than having just diabetes autoantibodies [24].…”

489 Low Yield of Routine Duodenal Biopsies in the Evaluation of Abdominal Pain

“…However, in patients felt to have a high probability of celiac disease (defined as > 5% by the ACG), duodenal biopsy is recommended based on guidelines [15][16][17][18][19][20][21][22] . This group may include patients with type 1 diabetes mellitus, a first-degree family member with celiac disease in the presence of clinical symptoms, or a positive or equivocal celiac serology for confirmation [23][24][25][26][27][28][29][30] . The limitations of this study include the retrospective nature of this study and that of a single center study at an academic medical center.…”

Type 1 Diabetes Mellitus Among Pediatrics and Adolescents in Saudi Arabia: A Systematic Review.

“…[2] Other forms of autoimmune disorders, such as celiac disease (CD) and thyroiditis (AIT), may increasingly affects T1DM patients. [3,4] Moreover, T1DM sequalae in children and adolescents involve acute complications such as hypoglycemia attacks, and diabetes ketoacidosis (DKA). Long-term complications microangiopathies in the retina and kidney as well as dyslipidemia were reported.…”