Study of celiac disease associated antibodies in type 1 diabetic patients and their first-degree relatives

Abstract EN

In type 1 diabetes the co-existence with organ specific autoantibodies has been reported.

Also, an association of type 1 diabetes with celiac disease (CD) has been described and many patients with CD are asymptomatic.

These disorders share a similar background and the first-degree relatives of type 1 diabetes mellitus may be also affected significantly.

Screening for specific antibodies allows early diagnosis of these disorders.

The aim of this work was to evaluate the celiac disease antibodies in a group of type 1 diabetes mellitus patients and their first-degree relatives.

Patients and methods: In the present study we analyzed sera from 100 recent onset typel diabetic patients, 100 of their first degree relatives, 60 sera of type 2 diabetic patients and sera of 60 healthy control subjects for the presence of the following antibodies: Tissue transglutaminase IgA (tTG) [ELISAj, anti-endomysial autoantibodies (AEA) [Indirect Immunoflourescence Assay], anti-gliadin IgA & IgG antibodies (A GA)[ELISAj, glutamic acid decarboxylase (GAD) antibodies [Qualitative ELISAj, insulin auto antibodies (IAA) [ELISAj and islet cell antibodies (ICA) [ELISAj.

Results: We identified 17 cases (17%) of type 1 recent onset diabetes patients as having CD specific autoantibodies, and 8 subjects (8%) of their first degree relatives compared to only 1 case (1.6%) of type 2 diabetic patients and 2 (3.3%) healthy control subjects, the differences were statistically significant (p<0.05).

The overall frequency of type 1 diabetes-associated antibodies and CD antibodies were significantly more frequent both in recent onset typel diabetics and in the group of first-degree relatives (p<0.05).

The prevalence of anti-gliadin IgG & IgA, anti-endomysial antibodies and tissue transglutaminase IgA in type 1 diabetes patients (11% & 9% & 7% 12%) respectively, p<0.05), and in the first-degree relatives (5% & 2% & 2% & 4%) respectively, p<0.05) were significantly higher than the control group (2% & 0% & 0% & 1%, respectively) and type 2 diabetes patients (0% & 1% & 0% & 1%, respectively).

A significant positive correlation was found between type 1 diabetes associated antibodies positivity and CD autoantibodies (r-3.2, p<0.05).

Conclusion: We concluded that, there is an increased prevalence of celiac disease antibodies in type 1 diabetic patients and their first-degree relatives.

The coexistence of type 1 diabetes autoantibodies and CD antibodies adds to the concept that CD and type 1 diabetes may share a similar immune and genetic background.

In an active case-finding strategy, recent onset type 1 diabetes patients and their first-degree relatives should be routinely screened for celiac disease autoantibodies.