Division of Pediatric Gastroenterology, Hepatology and Nutrition, Diyarbakir Children's Hospital, Diyarbakir, Turkey,
Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Health Sciences, Zeynep Kâmil Women & Children's Training & Research Hospital, Istanbul, Turkey,
Dig Dis. 2021;39(5):444-450. doi: 10.1159/000514276. Epub 2021 Jan 11.
Data regarding Helicobacter pylori (Hp) infection frequency in concurrent celiac disease (CD) and type 1 diabetes mellitus (T1DM) (CD + T1DM) are anecdotal. This study aimed to evaluate the association between Hp and concomitant CD + T1DM in children.
In this 2-center, case-control study, children who underwent esophago-gastro-duodenoscopy (EGD) were studied. CD diagnosis was established by favorable histology and serology. Hp infection was confirmed by both histology and the rapid urease test. Patients were divided into 3 groups as CD only (CDo), CD + T1DM, and non-CD children who underwent endoscopy as controls.
Among the 1,431 EGDs performed, 783 cases were eligible. Overall, 215 cases had CDo (mean age: 9.12 ± 4.18 years, 58.1% girls), 63 cases had CD + T1DM (mean age: 9.29 ± 4.46 years, 50.8% girls), and 505 cases were controls (mean age: 9.69 ± 4.52 years, 56.6% girls). Hp infection rate was significantly lower in CD + T1DM group (controls: 49.7% vs. CDo: 32.1% vs. CD + T1DM: 20.6%, p < 0.01). After adjustment for age, gender, and socioeconomic status, the Hp infection rate was still significantly low (adjusted odds ratio [aOR]: 1.57, 95% confidence interval (CI): 1.35-1.83, p < 0.01). A difference in Hp infection rate between controls and CDo group (aOR: 1.43, 95% CI: 1.09-2.12, p < 0.05), and between CDo and CD + T1DM (aOR: 0.89, 95% CI: 0.65-1.54, p < 0.05) group was significant. The severity of duodenal lesions and the presence of Hp infection were not correlated in all celiac children (r: 0.113, p > 0.05).
The frequency of Hp infection was significantly lower in CD + T1DM children, compared to the CDo group and the controls.
有关同时患有乳糜泻（CD）和 1 型糖尿病（T1DM）（CD+T1DM）患者中幽门螺杆菌（Hp）感染频率的数据仅为传闻。本研究旨在评估儿童中 Hp 与同时患有 CD+T1DM 的相关性。
在这项 2 中心病例对照研究中，对接受食管胃十二指肠镜检查（EGD）的儿童进行了研究。通过良好的组织学和血清学诊断 CD。通过组织学和快速尿素酶试验均确认 Hp 感染。将患者分为 3 组，即仅 CD（CDo）、CD+T1DM 和非 CD 接受内镜检查的对照组。
在进行的 1431 次 EGD 中，有 783 例符合条件。总体而言，215 例有 CDo（平均年龄：9.12±4.18 岁，58.1%为女孩），63 例有 CD+T1DM（平均年龄：9.29±4.46 岁，50.8%为女孩），505 例为对照组（平均年龄：9.69±4.52 岁，56.6%为女孩）。CD+T1DM 组的 Hp 感染率明显较低（对照组：49.7% vs. CDo：32.1% vs. CD+T1DM：20.6%，p<0.01）。在调整年龄、性别和社会经济地位后，Hp 感染率仍明显较低（调整后的优势比[aOR]：1.57，95%置信区间[CI]：1.35-1.83，p<0.01）。在对照组和 CDo 组之间（aOR：1.43，95%CI：1.09-2.12，p<0.05）和 CDo 与 CD+T1DM 组之间（aOR：0.89，95%CI：0.65-1.54，p<0.05），Hp 感染率的差异具有统计学意义。在所有乳糜泻儿童中，十二指肠病变的严重程度与 Hp 感染之间没有相关性（r：0.113，p>0.05）。
与 CDo 组和对照组相比，CD+T1DM 儿童的 Hp 感染频率明显较低。
