Araújo Jacqueline, da Silva Gisélia Alves Pontes, de Melo Francisco Montenegro
Endocrinologista pediatra, Instituto Materno-Infantil de Pernambuco (IMIP) e Hospital das Clínicas, Recife, PE, Brasil.
J Pediatr (Rio J). 2006 May-Jun;82(3):210-4. doi: 10.2223/JPED.1478. Epub 2006 May 23.
The association between celiac disease and diabetes mellitus has been known for many decades. This combination can be observed in a large proportion of diabetic patients, who are generally asymptomatic. The objective of this study was to evaluate the seroprevalence of celiac disease in children and adolescents with type 1 diabetes mellitus.
This was a cross-sectional study employing antibody IgA anti-transglutaminase for the serological screening of 354 diabetic children and adolescents treated at pediatric endocrinology clinics in Recife, state of Pernambuco, during the period from January to June 2004.
The human anti-transglutaminase test was positive in 37/354 patients, resulting in a seroprevalence of 10.5% (95%CI 7.6-14.2%). Male patients predominated (56.8%) over female patients (43.2%) among those that were seropositive, but without statistical significance. Anti-endomysial antibody testing was performed on patients with positive human anti-transglutaminase results, being negative in 14/37 (37.8%) and positive in 22/37 (59.5%).
The seroprevalence of celiac disease found in diabetic children and adolescents in Pernambuco is elevated, being comparable with levels observed in studies in North America and Europe and lower than in Africa, suggesting that serological screening for celiac disease should be performed for all children and adolescents with type 1 diabetes mellitus.
乳糜泻与糖尿病之间的关联已为人所知达数十年之久。在很大一部分糖尿病患者中都能观察到这种组合情况，而这些患者通常没有症状。本研究的目的是评估1型糖尿病儿童和青少年中乳糜泻的血清学患病率。
这是一项横断面研究，采用抗组织转谷氨酰胺酶IgA抗体对2004年1月至6月期间在伯南布哥州累西腓的儿科内分泌诊所接受治疗的354名糖尿病儿童和青少年进行血清学筛查。
37/354例患者的人抗组织转谷氨酰胺酶检测呈阳性，血清学患病率为10.5%（95%可信区间7.6 - 14.2%）。在血清学阳性患者中，男性患者（56.8%）多于女性患者（43.2%），但无统计学意义。对人抗组织转谷氨酰胺酶结果呈阳性的患者进行了抗肌内膜抗体检测，14/37（37.8%）为阴性；22/37（59.5%）为阳性。
在伯南布哥州糖尿病儿童和青少年中发现的乳糜泻血清学患病率有所升高，与北美和欧洲研究中观察到的水平相当，低于非洲，这表明应对所有1型糖尿病儿童和青少年进行乳糜泻的血清学筛查。
