Beta-cell autoimmunity in pediatric celiac disease: the case for routine screening?

Diabetes Care. 2009 Feb;32(2):254-6. doi: 10.2337/dc08-1487. Epub 2008 Nov 18.

Abstract

Objective: To evaluate the prevalence of beta-cell autoimmunity and the usefulness of a type 1 diabetes screening in patients with celiac disease.

Research design and methods: We measured GAD antibodies (GADAs), insulinoma-associated protein 2 antigens (IA-2As), and insulin autoantibodies (IAAs) in 188 young Italian patients with celiac disease (66 male [35.1%]). Mean age at celiac disease diagnosis was 5.4 years (0.5-17.1), and mean celiac disease duration was 4.2 years (0-28.8). Celiac disease was diagnosed by jejunal biopsy after positivity for endomysial and tissue transglutaminase antibody was confirmed.

Results: GADAs were positive in seven patients (3.7%), and IA-2As were positive in two patients. IAAs were negative in all cases. Metabolic evaluation was normal, and no patients developed diabetes during follow-up. There was no significant association among beta-cell autoimmunity and sex, age, pubertal stage, family history, or coexistence of other autoimmune disorders; compliance to a gluten-free diet was confirmed.

Conclusions: Our results showed a low prevalence of beta-cell autoimmunity and do not support a precocious screening for beta-cell autoimmunity in young celiac disease patients.

MeSH terms

  • Adolescent
  • Age of Onset
  • Autoantibodies / blood
  • Autoimmune Diseases / epidemiology*
  • Autoimmunity
  • Celiac Disease / immunology*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Insulin Antibodies / blood
  • Insulin-Secreting Cells / immunology*
  • Italy
  • Male

Substances

  • Autoantibodies
  • ICA512 autoantibody
  • Insulin Antibodies