Bhadada Sanjay Kumar, Rastogi Ashu, Agarwal Aakash, Kochhar Rashi, Kochhar Rakesh, Bhansali Anil
Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Med Res. 2017 Mar;145(3):334-338. doi: 10.4103/ijmr.IJMR_666_14.
BACKGROUND & OBJECTIVES: Celiac disease (CD) and type 1 diabetes mellitus (T1DM) share a common genetic locus and clinical manifestations. The present study was planned to compare clinical, biochemical and hormonal profiles of patients with CD and CD with T1DM.
Records of CD patients with age ≤20 yr, available anthropometric measurements, haematological, biochemical and hormonal workup with tissue transglutaminase IgA antibody and duodenal biopsy (Marsh grade) were screened. The patients were divided into two groups i.e., CD alone (Group A) and concurrent CD with T1DM (Group B).
One hundred and nine patients of CD (57 male) with a mean age of 14.9±2.9 yr were evaluated. Of these, 86 (78.9%) patients had CD alone and 23 (13 females) (21.1%) patients had CD with T1DM. The age at diagnosis and the lag duration for the diagnosis of CD were 11.5±4.6 versus 13.8±3.4 yr (P<0.05) and 48.8 ±43.3 versus 20.2±31.8 months (P<0.05) in groups A and B, respectively. The most common histopathological grade was type 3b (59.2%) in group A and type 2 (42.1%) in group B. Short stature (87% vs. 40.9%; P<0.01), anaemia (80.9% vs. 45%, P<0.01) and delayed puberty (61.9% vs. 29.4%; P<0.01) were more common in group A.
INTERPRETATION & CONCLUSIONS: Patients with CD alone have a longer lag time to diagnosis and consequent sequel in the form of anaemia, short stature and delayed puberty, as compared to patients with concurrent CD and T1DM.
乳糜泻(CD)和1型糖尿病(T1DM)具有共同的基因位点和临床表现。本研究旨在比较CD患者以及合并T1DM的CD患者的临床、生化和激素指标。
筛选年龄≤20岁的CD患者的记录,包括可用的人体测量数据、血液学、生化和激素检查结果,以及组织转谷氨酰胺酶IgA抗体和十二指肠活检(马什分级)。患者分为两组,即单纯CD组(A组)和合并T1DM的CD组(B组)。
对109例CD患者(57例男性)进行了评估,平均年龄为14.9±2.9岁。其中,86例(78.9%)患者为单纯CD,23例(13例女性)(21.1%)患者为合并T1DM的CD。A组和B组的诊断年龄和CD诊断延迟时间分别为11.5±4.6岁对13.8±3.4岁(P<0.05)和48.8±43.3个月对20.2±31.8个月(P<0.05)。A组最常见的组织病理学分级为3b型(59.2%),B组为2型(42.1%)。身材矮小(87%对40.9%;P<0.01)、贫血(80.9%对45%,P<0.01)和青春期延迟(61.9%对29.4%;P<0.01)在A组中更为常见。
与合并CD和T1DM的患者相比,单纯CD患者的诊断延迟时间更长,并且会出现贫血、身材矮小和青春期延迟等后遗症。