Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Gastroenterol Hepatol. 2011 Feb;26(2):378-81. doi: 10.1111/j.1440-1746.2010.06508.x.
There is scanty data on the occurrence of celiac disease in patients with type 1 diabetes mellitus in South Asia. Our aim was to study the prevalence and clinical profile of celiac disease in patients with type 1 diabetes mellitus in a tertiary care referral centre in north India.
Consecutive patients of type 1 diabetes mellitus attending the Endocrine clinic of our institute between January 2002 and December 2008 were screened using anti-tissue transglutaminase antibodies (tTGAb), and those positive were subjected to duodenal biopsy. Clinical profile of these patients was recorded.
Out of 189 patients of type 1 diabetes mellitus, 21 (11.1%) were diagnosed to have celiac disease on the basis of positive serology (tTGAb) and duodenal histology. The mean age at diagnosis of diabetes was 10.81 ± 7.3 years and that of celiac disease was 13.74 ± 5.71 years, with a difference of 5.18 ± 4.75 years between the two. Only 2/21 patients with celiac disease had been diagnosed before detection of diabetes mellitus. Short stature was the commonest (52.3%) manifestation of celiac disease, followed by anemia (47.3), weight loss (42.8%), diarrhea (28.6%) and abdominal pain (14.2%). After initiating gluten free diet, 14/16 symptomatic patients had reversal of anemia, weight loss and diarrhea. Growth rate velocity improved from 2.3 ± 1.0 cm/year to 5.5 ± 2.4 cm/year in those with short stature.
Celiac disease is highly prevalent in patients with type 1 diabetes mellitus (11.1%) and majority of them (90.5%) were diagnosed on screening. Routine screening is required for early diagnosis and combat associated co-morbidities.
在南亚，关于 1 型糖尿病患者中乳糜泻发生的数据很少。我们的目的是研究印度北部一家三级转诊中心的 1 型糖尿病患者中乳糜泻的患病率和临床特征。
在 2002 年 1 月至 2008 年 12 月期间，我们连续筛查了我院内分泌科就诊的 1 型糖尿病患者，使用抗组织转谷氨酰胺酶抗体（tTGAb）进行筛查，抗体阳性者行十二指肠活检。记录这些患者的临床特征。
在 189 例 1 型糖尿病患者中，有 21 例（11.1%）根据血清学（tTGAb）和十二指肠组织学检测结果诊断为乳糜泻。糖尿病的平均诊断年龄为 10.81 ± 7.3 岁，乳糜泻的平均诊断年龄为 13.74 ± 5.71 岁，两者相差 5.18 ± 4.75 岁。在检测到糖尿病之前，仅有 2/21 例乳糜泻患者被诊断为该病。乳糜泻最常见的表现是身材矮小（52.3%），其次是贫血（47.3%）、体重减轻（42.8%）、腹泻（28.6%）和腹痛（14.2%）。在开始无麸质饮食后，14/16 例有症状的患者贫血、体重减轻和腹泻得到逆转。在身材矮小的患者中，生长速度从 2.3 ± 1.0 cm/年增加到 5.5 ± 2.4 cm/年。
1 型糖尿病患者中乳糜泻的患病率很高（11.1%），其中大多数（90.5%）是通过筛查发现的。为了早期诊断和防治相关合并症，需要进行常规筛查。
