Djurić Zlatko, Stamenković Hristina, Stanković Tatjana, Milićević Radovan, Branković Ljiljana, Cirić Vesna, Katić Vuka
Department of Gastroenterology, Children's Hospital, University of Niš School of Medicine, Niš, Serbia.
Pediatr Int. 2010 Aug;52(4):579-83. doi: 10.1111/j.1442-200X.2010.03085.x.
The association between celiac disease (CD) and type 1 diabetes mellitus (T1DM) is well known. Up to now, CD prevalence in children and adolescents with T1DM in Serbia has not been reported. The aim of the present study was to determine CD prevalence and its clinical manifestations in patients with T1DM.
One hundred and twenty-one patients (70 girls, 51 boys; mean age, 10.8 years) with T1DM (mean duration of diabetes, 3.4 years) and 125 control group participants (75 girls, 50 boys; mean age, 10.4 years) were tested for CD on tissue transglutaminase antibodies (tTG). In seven serologically positive T1DM patients endoscopic small bowel biopsies were taken and examined on histopathology. In all patients with CD and T1DM age, duration of T1DM, height for age, body mass index, glycosylated hemoglobin and clinical symptoms were noted.
Nine patients with T1DM were positive on IgA tTG antibodies. In seven of them small bowel biopsy was performed, and all were proven to have CD on histopathology. The prevalence of biopsy-proven CD in children and adolescents with T1DM was significantly higher in the study group compared to controls (5.79%. vs 0.8%, P < 0.05).
The significantly higher prevalence of CD in children with type 1 diabetes, in accordance with the large volume of data published in the literature, underlines the need for yearly screening of CD in patients with diabetes in order to promptly start a gluten-free diet when appropriate.
乳糜泻（CD）与1型糖尿病（T1DM）之间的关联已广为人知。截至目前，塞尔维亚T1DM儿童和青少年中的CD患病率尚未见报道。本研究的目的是确定T1DM患者中CD的患病率及其临床表现。
对121例T1DM患者（70名女孩，51名男孩；平均年龄10.8岁；糖尿病平均病程3.4年）和125名对照组参与者（75名女孩，50名男孩；平均年龄10.4岁）进行组织转谷氨酰胺酶抗体（tTG）检测以筛查CD。对7例血清学阳性的T1DM患者进行内镜下小肠活检，并进行组织病理学检查。记录所有CD合并T1DM患者的年龄、T1DM病程、身高别年龄、体重指数、糖化血红蛋白及临床症状。
9例T1DM患者IgA tTG抗体呈阳性。其中7例进行了小肠活检，组织病理学检查均证实患有CD。研究组中经活检证实的T1DM儿童和青少年CD患病率显著高于对照组（5.79%对0.8%，P<0.05）。
1型糖尿病儿童中CD患病率显著更高，与文献中大量发表的数据一致，这突出表明有必要对糖尿病患者每年进行CD筛查，以便在适当的时候及时开始无麸质饮食。
