Sari Sinan, Yeşilkaya Ediz, Eğritaş Odül, Bideci Aysun, Cinaz Peyami, Dalgiç Buket
Department of Pediatric Gastroenterology, Gazi University, School of Medicine, Ankara, Turkey.
Turk J Gastroenterol. 2010 Mar;21(1):34-8. doi: 10.4318/tjg.2010.0045.
BACKGROUND/AIMS: The objective of this study was to determine the prevalence of Celiac disease in Turkish children with type 1 Diabetes Mellitus and their non-diabetic first-degree relatives.
Forty-eight children with type 1 Diabetes Mellitus (18 males, 30 females; age range: 3.5 to 23 years; mean age: 12.09 +/- 4.78 years), 29 non-diabetic siblings, 40 non-diabetic parents, and 103 healthy children were screened for celiac disease using the IgA and IgG anti-tissue transglutaminase antibody and total serum IgA. Small intestinal biopsy was offered to all antibody-positive patients.
Eight of 48 diabetic patients had positive anti-tissue transglutaminase IgA. Selective IgA deficiency was detected in 2 diabetic children and both were positive to anti-tissue transglutaminase IgG. Intestinal biopsy was accepted by 8 of 10 (80%) diabetic children with positive celiac serology. Pathologic examination showed total villous atrophy in 3 (6.3%) diabetic children. Positive anti-tissue transglutaminase IgA was found in 1/29 siblings and 2/40 parents. Celiac disease was confirmed by biopsy in the sibling. Two parents refused the biopsy. The frequency of biopsy-proven celiac disease was found as 1.4 in relatives of diabetic children. None of the serum samples of healthy children comprising the control group showed selective IgA deficiency or positivity for anti-tissue transglutaminase IgA antibody.
These findings indicate that the prevalence of celiac disease in Turkish children with type 1 diabetes mellitus is higher than in healthy controls. The 1.4% frequency of Celiac disease in relatives of diabetic children is close to that of controls.
背景/目的：本研究的目的是确定1型糖尿病土耳其儿童及其非糖尿病一级亲属中乳糜泻的患病率。
对48例1型糖尿病儿童（18例男性，30例女性；年龄范围：3.5至23岁；平均年龄：12.09±4.78岁）、29例非糖尿病兄弟姐妹、40例非糖尿病父母和103例健康儿童进行乳糜泻筛查，检测指标包括IgA和IgG抗组织转谷氨酰胺酶抗体以及总血清IgA。所有抗体阳性患者均接受小肠活检。
48例糖尿病患者中有8例抗组织转谷氨酰胺酶IgA呈阳性。在2例糖尿病儿童中检测到选择性IgA缺乏，且这2例儿童的抗组织转谷氨酰胺酶IgG均呈阳性。10例乳糜泻血清学阳性的糖尿病儿童中有8例（80%）接受了肠道活检。病理检查显示3例（6.3%）糖尿病儿童存在全绒毛萎缩。在29例兄弟姐妹中有1例、40例父母中有2例抗组织转谷氨酰胺酶IgA呈阳性。该兄弟姐妹经活检确诊为乳糜泻。2例父母拒绝活检。在糖尿病儿童亲属中，经活检证实的乳糜泻发生率为1.4%。作为对照组的健康儿童血清样本中，无一例显示选择性IgA缺乏或抗组织转谷氨酰胺酶IgA抗体阳性。
这些发现表明，1型糖尿病土耳其儿童中乳糜泻的患病率高于健康对照组。糖尿病儿童亲属中乳糜泻的发生率为1.4%，与对照组相近。
