Remes-Troche José María, Rios-Vaca Aurelio, Ramírez-Iglesias María Teresa, Rubio-Tapia Alberto, Andrade-Zarate Vicente, Rodríguez-Vallejo Fanny, López-Maldonado Francisco, Gomez-Perez Francisco Javier, Uscanga Luis F
Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
J Clin Gastroenterol. 2008 May-Jun;42(5):460-5. doi: 10.1097/MCG.0b013e318046ea86.
Recent studies have shown that celiac disease (CD) could affect 0.5% to 3% of the general population, including Mexican Mestizos, which represents a complex mixture of genetics, and constitutes the core of Mexican and Latin American populations. However, the association between CD and other conditions, specifically type-1 diabetes mellitus, in this population remains unknown. Thus, our aim was to determine the prevalence of both serologic and biopsy proven CD in Mexican Mestizo adults with type-1 diabetes.
Over a 6-month period, serum samples obtained from consecutive Mexican Mestizo adult patients (age >or=18 y) with type-1 diabetes were tested with a new generation human recombinant protein based IgA tissue transglutaminase enzyme-linked immunosorbent assay commercial kit. All patients with positive serologic test results underwent upper gastrointestinal endoscopy and small intestinal biopsies to confirm CD.
Eighty-four type-1 diabetic patients were included (62 women, mean age 28.9+/-9 y). Overall, 9 patients (9/84) were positive for IgA tissue transglutaminase with a point prevalence of 10.7% (95% CI, 4%-17%). Seven patients agreed to undergo endoscopy. Five subjects had biopsy-proven CD (5.9%, 95% CI, 1.9%-13.3%). One patient had chronic diarrhea and other abdominal bloating; whereas the remaining 3 were asymptomatic. CD associated type-1 diabetic patients tended to have higher hemoglobin A1c levels (P=0.07), reflecting poor glycemic control.
As in other populations, we demonstrated a high prevalence of biopsy-proven CD (5.9%) among Mexican Mestizo patients with type-1 diabetes. Clinicians should be aware of this common association in this ethnic group.
近期研究表明，乳糜泻（CD）在普通人群中的发病率为0.5%至3%，其中包括墨西哥梅斯蒂索人，该群体具有复杂的遗传混合特征，是墨西哥和拉丁美洲人口的核心组成部分。然而，该人群中CD与其他疾病，特别是1型糖尿病之间的关联尚不清楚。因此，我们的目的是确定1型糖尿病的墨西哥梅斯蒂索成年患者中血清学和活检证实的CD的患病率。
在6个月的时间里，使用新一代基于人重组蛋白的IgA组织转谷氨酰胺酶酶联免疫吸附测定商业试剂盒，对连续纳入的1型糖尿病墨西哥梅斯蒂索成年患者（年龄≥18岁）的血清样本进行检测。所有血清学检测结果呈阳性的患者均接受上消化道内镜检查和小肠活检以确诊CD。
纳入了84例1型糖尿病患者（62名女性，平均年龄28.9±9岁）。总体而言，9例患者（9/84）的IgA组织转谷氨酰胺酶检测呈阳性，点患病率为10.7%（95%CI，4% - 17%）。7例患者同意接受内镜检查。5例患者经活检证实患有CD（5.9%，95%CI，1.9% - 13.3%）。1例患者有慢性腹泻和其他腹胀症状；其余3例无症状。与CD相关的1型糖尿病患者的糖化血红蛋白水平往往较高（P = 0.07），反映出血糖控制不佳。
与其他人群一样，我们证明了在患有1型糖尿病的墨西哥梅斯蒂索患者中，经活检证实的CD患病率较高（5.9%）。临床医生应意识到该种族群体中这种常见的关联。
