Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children's Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warsaw, Poland.
Department of Endocrinology and Diabetology, The Children's Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warsaw, Poland.
Nutrients. 2022 Jan 18;14(3):414. doi: 10.3390/nu14030414.
Patients with type 1 diabetes (T1D) are at higher risk of celiac disease (CD). Recently, intestinal fatty acid binding protein (I-FABP) has been shown to be a serological biomarker of impaired intestinal barrier in CD. Thus, the aim of this study was to verify whether I-FABP could be an early marker of CD in pediatric T1D patients. I-FABP was measured in sera of patients with T1D (n = 156), active CD (n = 38), T1D with active CD (T1D-CD, n= 51), and age-matched healthy children (n = 55). Additionally, I-FABP was determined in T1D patients with negative CD serology at least one year before CD diagnosis (T1D-CD-1, n = 22), in CD patients on a gluten-free diet (CD-GFD, n = 36), and T1D-CD patients on GFD (T1D-CD-GFD, n = 39). Sera were tested using immunoenzymatic assay. Significantly increased levels of I-FABP were found in the T1D, active CD, and T1D-CD groups (1153 ± 665, 1104 ± 916, and 1208 ± 878, respectively) in comparison to healthy with controls (485 ± 416, p < 0.05). GFD induced a significant decrease in I-FABP levels in CD and T1D-CD groups (510 ± 492 and 548 ± 439, respectively). Interestingly, in T1D-CD-1 and T1D, I-FABP levels were comparable (833 ± 369 vs. 1153 ± 665), and significantly increased in relation to healthy controls and T1D-CD values on GFD. The results indicate that the epithelial barrier is disrupted in T1D patients independently of CD development; therefore, I-FABP cannot serve as an early marker of CD in T1D patients. Although GFD can improve epithelial recovery, the question remains as to whether GFD could exert beneficial effects on the intestinal barrier in early stages of T1D.
1 型糖尿病（T1D）患者患乳糜泻（CD）的风险较高。最近，肠脂肪酸结合蛋白（I-FABP）已被证明是 CD 中肠道屏障受损的血清生物标志物。因此，本研究旨在验证 I-FABP 是否可作为儿科 T1D 患者 CD 的早期标志物。在 T1D 患者（n=156）、活动性 CD（n=38）、T1D 合并活动性 CD（T1D-CD，n=51）和年龄匹配的健康儿童（n=55）的血清中测量了 I-FABP。此外，还在 CD 血清学阴性至少一年后被诊断为 CD 的 T1D 患者（T1D-CD-1，n=22）、接受无麸质饮食（CD-GFD，n=36）的 CD 患者和接受 GFD 的 T1D-CD 患者（T1D-CD-GFD，n=39）中测定了 I-FABP。使用免疫酶联测定法检测血清。与健康对照组相比，T1D、活动性 CD 和 T1D-CD 组的 I-FABP 水平显著升高（分别为 1153±665、1104±916 和 1208±878）（p<0.05）。GFD 可使 CD 和 T1D-CD 组的 I-FABP 水平显著降低（分别为 510±492 和 548±439）。有趣的是，在 T1D-CD-1 和 T1D 中，I-FABP 水平相当（833±369 与 1153±665），与健康对照组和 GFD 下的 T1D-CD 值相比显著升高。结果表明，T1D 患者的上皮屏障受损与 CD 无关；因此，I-FABP 不能作为 T1D 患者 CD 的早期标志物。尽管 GFD 可改善上皮细胞的恢复，但仍存在一个问题，即 GFD 是否可在 T1D 的早期阶段对肠道屏障产生有益影响。
