Kaspers Stefan, Kordonouri Olga, Schober Edith, Grabert Matthias, Hauffa Berthold P, Holl Reinhard W
University Children's Hospital, Essen, Germany.
J Pediatr. 2004 Dec;145(6):790-5. doi: 10.1016/j.jpeds.2004.07.031.
To investigate the influence of celiac disease (CD) on growth and metabolic control in a nationwide cohort of children and adolescents with type 1 diabetes (T1D).
We analyzed data from 19,796 pediatric patients with T1D in the German pediatric multicenter DPV-database for occurrence of CD.
CD-specific antibodies were present in 1326 patients (6.7%). The diagnosis was confirmed in 127 patients (0.6%) by small-bowel biopsy. Female subjects were significantly more predisposed to have T1D and CD. The CD-affected patients in our cohort were significantly younger at diabetes onset. Furthermore, they had significantly lower height-SDS at onset (-0.49 vs -0.06, P < .05), a difference that increased during the course of the disease (-0.80 vs -0.26 after 9 years of diabetes, P < .05). In addition, body mass index-SDS significantly differed between the groups (0.22 vs 0.47, P < .05). Evidence for thyroid disease was more commonly observed in the T1D with CD group (6.3% vs 2.3%, P < .05). HbA1c values were lower in the patients with T1D and CD.
The CD-positive patients were characterized by earlier onset of diabetes and decreased growth and weight gain. These findings emphasize the clinical relevance of celiac disease in patients with autoimmune diabetes.
在全国范围内的1型糖尿病（T1D）儿童和青少年队列中，研究乳糜泻（CD）对生长和代谢控制的影响。
我们分析了德国儿科多中心DPV数据库中19796例T1D儿科患者的CD发生数据。
1326例患者（6.7%）存在CD特异性抗体。经小肠活检，127例患者（0.6%）确诊为CD。女性受试者患T1D和CD的倾向明显更高。我们队列中受CD影响的患者糖尿病发病时年龄显著更小。此外，发病时他们的身高标准差评分显著更低（-0.49对-0.06，P<.05），这种差异在疾病过程中有所增加（糖尿病9年后为-0.80对-0.26，P<.05）。此外，两组间体重指数标准差评分也存在显著差异（0.22对0.47，P<.05）。在T1D合并CD组中，甲状腺疾病的证据更为常见（6.3%对2.3%，P<.05）。T1D合并CD患者的糖化血红蛋白（HbA1c）值更低。
CD阳性患者具有糖尿病发病早、生长发育和体重增加减少的特点。这些发现强调了乳糜泻在自身免疫性糖尿病患者中的临床相关性。
