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Prevalence of silent celiac disease in adult egyptian patients with type 1 diabetes mellitus

Ahmed Abd Elmoaty Elnaggar, Hesham Mahmoud Abdullah, Khalid Faragkassem, Salma Mohamed Hosameldin, Dina Sabry Abdel Fattah, Waleed Elnabawy


Background and purpose: Celiac disease is a disorder primarily affecting gastrointestinal tract causing chronic inflammation to the mucosa and a permanent state of intolerance to gluten. A strong association has been observed between celiac disease and type 1 DM. This is important because the treatment of asymptomatic patients with type 1 DM having a gluten-free diet seems to have a positive effect on glycemic control and on the growth. This study was done to detect the prevalence of silent celiac disease in adult patients with type 1 diabetes mellitus by using serological immune-enzymatic tests (anti tissue transglutaminase antibodies). Study design: case-control study. Subjects: Ninety adult cases with type 1 DM compared to 48 adult healthy individuals aged between 20 and 40 years. Place: Internal medicine department, Kasr Al Ainy Hospitals Method: This is a prospective case-control study conducted on 90 adult cases with type 1DM compared to 48 adult healthy individuals aged between 20 and 40 years. All patients were subjected to routine labs, HbA1c, Anti TTG-IgA and selected Anti TTG-IgG in IgA negative cases. Assessment: The assessment was carried out by obtaining full medical history and history of diabetes mellitus. Laboratory work was done in the form routine labs, HbA1c and anti-tissue transglutaminase antibody as a predictor marker for celiac disease. The gained measures were analyzed by using SPSS program, t-test and chi-square were used to compare between groups. Results: The mean age of the cases was 28.2 ± 6.26 years, 47.1 % males and 52.9% females with no statistically significant difference regarding age or sex between cases and controls. Mean duration of diabetes was 10.62 years ±7.13. Mean HbA1c was 8.92 ± 1.5 in cases while in non-diabetic (control) was 5.26 ± 0.6. Anti TTG was (100 %) negative in controls while in diabetics, Anti TTG was positive in (61.1%). Among Anti TTG IgA negative diabetic patients, only 3 cases (5.3%) were weak positive and 2 cases (3.5%) were strong positive for Anti TTG Ig G while the remaining 91.2% were negative. Conclusion: Celiac disease seems to be under investigated in patients with type 1 diabetes mellitus. There was increased prevalence of anti-tissue transglutaminase antibodies in adult patients with type 1 diabetes mellitus in comparison to a control group.

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