β-Cell Autoimmunity in Pediatric Celiac Disease: The Case for Routine Screening?

  1. Giuseppe d'Annunzio, MD1,
  2. Alessandro Giannattasio, MD1,
  3. Elena Poggi, MD1,
  4. Emanuela Castellano, MD2,
  5. Angela Calvi, MD2,
  6. Angela Pistorio, MD3,
  7. Arrigo Barabino, MD2 and
  8. Renata Lorini, MD1
  1. 1Department of Pediatrics, University of Genoa, IRCCS G. Gaslini Institute, Genoa, Italy
  2. 2Department Service of Gastroenterology, IRCCS G. Gaslini Institute, Genoa, Italy
  3. 3Epidemiology and Biostatistics Unit, IRCCS G. Gaslini Institute, Genoa, Italy
  1. Corresponding author: Giuseppe d'Annunzio, giuseppedannunzio{at}ospedale-gaslini.ge.it

Abstract

OBJECTIVE—To evaluate the prevalence of β-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 β-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 β-cell autoimmunity and do not support a precocious screening for β-cell autoimmunity in young celiac disease patients.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 18 November 2008.

    Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted November 4, 2008.
    • Received August 13, 2008.
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  1. Published online before print November 18, 2008, doi: 10.2337/dc08-1487 Diabetes Care February 2009 vol. 32 no. 2 254-256
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