High Prevalence of Celiac Disease in Mexican Mestizo Adults With Type 1 Diabetes Mellitus.
Remes-Troche, Jose Maria MD *; Rios-Vaca, Aurelio MD +; Ramirez-Iglesias, Maria Teresa BQ *; Rubio-Tapia, Alberto MD *; Andrade-Zarate, Vicente MD +; Rodriguez-Vallejo, Fanny MD +; Lopez-Maldonado, Francisco MD +; Gomez-Perez, Francisco Javier +; Uscanga, Luis F. MD, FACG *
Journal of Clinical Gastroenterology.
42(5):460-465, May/June 2008.
(Format: HTML, PDF)
Background and Aims: Recent studies have shown that celiac disease (CD) could affect 0.5% to 3% of the general population, including Mexican Mestizos, which represents a complex mixture of genetics, and constitutes the core of Mexican and Latin American populations. However, the association between CD and other conditions, specifically type-1 diabetes mellitus, in this population remains unknown. Thus, our aim was to determine the prevalence of both serologic and biopsy proven CD in Mexican Mestizo adults with type-1 diabetes.
Methods: Over a 6-month period, serum samples obtained from consecutive Mexican Mestizo adult patients (age >=18 y) with type-1 diabetes were tested with a new generation human recombinant protein based IgA tissue transglutaminase enzyme-linked immunosorbent assay commercial kit. All patients with positive serologic test results underwent upper gastrointestinal endoscopy and small intestinal biopsies to confirm CD.
Results: Eighty-four type-1 diabetic patients were included (62 women, mean age 28.9 /-9 y). Overall, 9 patients (9/84) were positive for IgA tissue transglutaminase with a point prevalence of 10.7% (95% CI, 4%-17%). Seven patients agreed to undergo endoscopy. Five subjects had biopsy-proven CD (5.9%, 95% CI, 1.9%-13.3%). One patient had chronic diarrhea and other abdominal bloating; whereas the remaining 3 were asymptomatic. CD associated type-1 diabetic patients tended to have higher hemoglobin A1c levels (P=0.07), reflecting poor glycemic control.
Conclusions: As in other populations, we demonstrated a high prevalence of biopsy-proven CD (5.9%) among Mexican Mestizo patients with type-1 diabetes. Clinicians should be aware of this common association in this ethnic group.
(C) 2008 by Lippincott Williams & Wilkins