The prevalence and risk factors for coeliac disease among children and adolescents with type 1 diabetes mellitus

AimsOur aim was to determine in children with T1DM the prevalence of positive antibodies against tissue transglutaminase (anti-tTG IgA) as indices of coeliac disease (CD), as well as its clinical presentation, its determinants and its association with thyroid (anti-TG, anti-TPO) and pancreatic b-cell autoimmunity (anti-GAD).MethodsThe study included 105 children and adolescents with T1DM, aged (mean ± SD) 12.44 ± 4.76 years, with a T1DM duration of 4.41 ± 3.70 years.ResultsFifty of our patients (47.6%) were positive for anti-GAD, 9/105 (8.6%) for anti-tTG IgA and 21/105(20%) for anti-thyroid antibodies. The anti-tTG IgA (+) children, in comparison with the rest of the study population, were of younger age (9.31 vs. 12.74 years, p = 0.038), shorter diabetes duration (2.16 vs. 4.62 years, p = 0.056) and had mild growth impairment (height SDS: −0.55 vs. +0.20, p = 0.055). Univariate logistic regression analysis revealed that the presence of anti-tTG IgA (+) was associated with younger age and shorter T1DM duration. Only 5/9 (55.6%) children with high titres of anti-tTG IgA developed mild gastrointestinal symptoms or growth retardation and had histological findings typical of CD.ConclusionsThe prevalence of anti-tTG IgA positivity among T1DM children was 8.6% and its occurrence was associated with younger age and short diabetes duration. Since CD presents in T1DM patients asymptomatically or with non-specific symptoms, periodic autoantibody screening is necessary for its early diagnosis.