Hansen D, Bennedbaek F N, Hansen L K, Høier-Madsen M, Hegedü L S, Jacobsen B B, Husby S
Departments of Paediatrics, University Hospital, Odense, Denmark.
Acta Paediatr. 2001 Nov;90(11):1238-43.
The purpose of this population-based study was to determine the prevalence of coeliac disease (CD) in 106 Danish children (age 2-18 y) with type I diabetes mellitus compared with 106 age- and sex-matched healthy controls. Serum samples were analysed for immunoglobulin A (IgA) and IgG gliadin antibodies by enzyme-linked immunosorbent assay (ELISA), for IgA endomysium antibodies (EMA) by immunofluorescence and for IgA tissue transglutaminase antibodies (tTGA) by ELISA. None of the controls had EMA or tTGA. Two diabetics previously diagnosed with CD were antibody negative on a gluten-free diet. Ten diabetics had both EMA and tTGA. Intestinal biopsy was performed in nine of them. All biopsies showed a histological picture of partial or total villous atrophy confirming the diagnosis of CD. Diabetics with CD were significantly younger (p = 0.026). had an earlier onset of diabetes (p = 0.005), had a lower height standard deviation score (p = 0.019) and more often had thyroid antibodies (p = 0.040) compared with diabetics without CD.
A high prevalence of CD of 10.4% (95% confidence interval 4.6-16.2%) was found in young Danish diabetics. Early onset of diabetes may predispose to CD. Routine serological screening for CD may be valuable in patients with type I diabetes mellitus.
本基于人群的研究旨在确定106名2至18岁的丹麦1型糖尿病儿童与106名年龄和性别匹配的健康对照者中乳糜泻(CD)的患病率。通过酶联免疫吸附测定(ELISA)分析血清样本中的免疫球蛋白A(IgA)和IgG麦醇溶蛋白抗体,通过免疫荧光分析IgA肌内膜抗体(EMA),通过ELISA分析IgA组织转谷氨酰胺酶抗体(tTGA)。所有对照者均无EMA或tTGA。两名先前诊断为CD的糖尿病患者在无麸质饮食时抗体呈阴性。10名糖尿病患者同时有EMA和tTGA。其中9人进行了肠道活检。所有活检均显示部分或完全绒毛萎缩的组织学图像,证实为CD诊断。与无CD的糖尿病患者相比,患有CD的糖尿病患者明显更年轻(p = 0.026),糖尿病发病更早(p = 0.005),身高标准差评分更低(p = 0.019),且更常出现甲状腺抗体(p = 0.040)。
在丹麦年轻糖尿病患者中发现CD的患病率高达10.4%(95%置信区间4.6 - 16.2%)。糖尿病的早发可能易患CD。对1型糖尿病患者进行CD的常规血清学筛查可能有价值。