1型糖尿病儿童的乳糜泻:筛查的有效性-单一中心25年的经验

IF 5.6 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Pediatric Diabetes Pub Date : 2025-08-01 eCollection Date: 2025-01-01 DOI:10.1155/pedi/4717290
Roland Schweizer, Julia I Bung, David Majer, Franziska Liebrich, Susann Herrlich, Andreas Neu, Julian Ziegler
{"title":"1型糖尿病儿童的乳糜泻:筛查的有效性-单一中心25年的经验","authors":"Roland Schweizer, Julia I Bung, David Majer, Franziska Liebrich, Susann Herrlich, Andreas Neu, Julian Ziegler","doi":"10.1155/pedi/4717290","DOIUrl":null,"url":null,"abstract":"<p><p><b>Objective:</b> Children with type 1 diabetes (T1D) have an increased risk of developing additional autoimmune diseases. The risk of developing celiac disease (CD) is 3-4 times higher in children with T1D. Guidelines recommend regular screening for transglutaminase antibodies (TgAbs) in T1D children. CD could be an additional burden for T1D children as both diseases affect food intake. We describe the screening practice for CD during the last 25 years in our outpatient clinic in children with T1D. <b>Methods:</b> We retrospectively analyzed the development of CD-specific antibodies in our children with T1D (diabetes onset since 1998). We did not routinely recommend endoscopy when CD-specific antibodies (TgAb, endomysium [EAb], and gliadin) were positive and patients had no CD-specific symptoms. <b>Results:</b> We analyzed 304 patients. In total 122 had CD-specific antibodies. In 98 of them, they disappeared after a short time or had been only slightly elevated. The diagnosis of CD was confirmed in 12. All 12 showed CD-specific symptoms, such as failure to thrive, anemia, hypoglycemia, or gastrointestinal problems. In six patients, even severely elevated EAb and/or TgAb disappeared on average after 7.1 years (range 4.9-13.5 years) on gluten-containing diet. The remaining six had antibodies without CD-specific symptoms by the end of the observation period. In this group the duration of antibody-positivity was 4 years (range 1.8-11.6 years). <b>Conclusion:</b> We conclude that even highly elevated CD-specific antibodies can disappear in children with T1D and that screening for CD-specific antibodies is therefore only useful in symptomatic children with T1D.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2025 ","pages":"4717290"},"PeriodicalIF":5.6000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334288/pdf/","citationCount":"0","resultStr":"{\"title\":\"Celiac Disease in Children With Type 1 Diabetes: The Usefulness of Screening- 25 years of Experience in a Single Center.\",\"authors\":\"Roland Schweizer, Julia I Bung, David Majer, Franziska Liebrich, Susann Herrlich, Andreas Neu, Julian Ziegler\",\"doi\":\"10.1155/pedi/4717290\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Objective:</b> Children with type 1 diabetes (T1D) have an increased risk of developing additional autoimmune diseases. The risk of developing celiac disease (CD) is 3-4 times higher in children with T1D. Guidelines recommend regular screening for transglutaminase antibodies (TgAbs) in T1D children. CD could be an additional burden for T1D children as both diseases affect food intake. We describe the screening practice for CD during the last 25 years in our outpatient clinic in children with T1D. <b>Methods:</b> We retrospectively analyzed the development of CD-specific antibodies in our children with T1D (diabetes onset since 1998). We did not routinely recommend endoscopy when CD-specific antibodies (TgAb, endomysium [EAb], and gliadin) were positive and patients had no CD-specific symptoms. <b>Results:</b> We analyzed 304 patients. In total 122 had CD-specific antibodies. In 98 of them, they disappeared after a short time or had been only slightly elevated. The diagnosis of CD was confirmed in 12. All 12 showed CD-specific symptoms, such as failure to thrive, anemia, hypoglycemia, or gastrointestinal problems. In six patients, even severely elevated EAb and/or TgAb disappeared on average after 7.1 years (range 4.9-13.5 years) on gluten-containing diet. The remaining six had antibodies without CD-specific symptoms by the end of the observation period. In this group the duration of antibody-positivity was 4 years (range 1.8-11.6 years). <b>Conclusion:</b> We conclude that even highly elevated CD-specific antibodies can disappear in children with T1D and that screening for CD-specific antibodies is therefore only useful in symptomatic children with T1D.</p>\",\"PeriodicalId\":19797,\"journal\":{\"name\":\"Pediatric Diabetes\",\"volume\":\"2025 \",\"pages\":\"4717290\"},\"PeriodicalIF\":5.6000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334288/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Diabetes\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1155/pedi/4717290\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Diabetes","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/pedi/4717290","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0

摘要

目的:1型糖尿病(T1D)患儿发生其他自身免疫性疾病的风险增加。患乳糜泻(CD)的风险是患T1D儿童的3-4倍。指南建议T1D儿童定期筛查转谷氨酰胺酶抗体(TgAbs)。乳糜泻可能是T1D儿童的额外负担,因为这两种疾病都会影响食物摄入。我们描述了过去25年在我们门诊的T1D儿童乳糜泻筛查实践。方法:回顾性分析1998年起发病的T1D患儿cd特异性抗体的发展情况。当cd特异性抗体(TgAb、肌内膜[EAb]和麦胶蛋白)呈阳性且患者没有cd特异性症状时,我们不常规推荐内窥镜检查。结果:我们分析了304例患者。总共122人有cd特异性抗体。在其中的98例中,它们在短时间内消失,或者只是略微升高。12例确诊为乳糜泻。所有12例患者均表现出cd特异性症状,如发育不良、贫血、低血糖或胃肠道问题。在6例患者中,即使严重升高的EAb和/或TgAb在含麸质饮食7.1年后(范围4.9-13.5年)平均消失。其余6人在观察期结束时没有cd特异性症状的抗体。本组抗体阳性持续时间为4年(1.8 ~ 11.6年)。结论:我们得出结论,即使高度升高的cd特异性抗体也可以在T1D儿童中消失,因此cd特异性抗体筛查仅对有症状的T1D儿童有用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Celiac Disease in Children With Type 1 Diabetes: The Usefulness of Screening- 25 years of Experience in a Single Center.

Celiac Disease in Children With Type 1 Diabetes: The Usefulness of Screening- 25 years of Experience in a Single Center.

Objective: Children with type 1 diabetes (T1D) have an increased risk of developing additional autoimmune diseases. The risk of developing celiac disease (CD) is 3-4 times higher in children with T1D. Guidelines recommend regular screening for transglutaminase antibodies (TgAbs) in T1D children. CD could be an additional burden for T1D children as both diseases affect food intake. We describe the screening practice for CD during the last 25 years in our outpatient clinic in children with T1D. Methods: We retrospectively analyzed the development of CD-specific antibodies in our children with T1D (diabetes onset since 1998). We did not routinely recommend endoscopy when CD-specific antibodies (TgAb, endomysium [EAb], and gliadin) were positive and patients had no CD-specific symptoms. Results: We analyzed 304 patients. In total 122 had CD-specific antibodies. In 98 of them, they disappeared after a short time or had been only slightly elevated. The diagnosis of CD was confirmed in 12. All 12 showed CD-specific symptoms, such as failure to thrive, anemia, hypoglycemia, or gastrointestinal problems. In six patients, even severely elevated EAb and/or TgAb disappeared on average after 7.1 years (range 4.9-13.5 years) on gluten-containing diet. The remaining six had antibodies without CD-specific symptoms by the end of the observation period. In this group the duration of antibody-positivity was 4 years (range 1.8-11.6 years). Conclusion: We conclude that even highly elevated CD-specific antibodies can disappear in children with T1D and that screening for CD-specific antibodies is therefore only useful in symptomatic children with T1D.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Pediatric Diabetes
Pediatric Diabetes 医学-内分泌学与代谢
CiteScore
6.60
自引率
14.70%
发文量
141
审稿时长
4-8 weeks
期刊介绍: Pediatric Diabetes is a bi-monthly journal devoted to disseminating new knowledge relating to the epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes in childhood and adolescence. The aim of the journal is to become the leading vehicle for international dissemination of research and practice relating to diabetes in youth. Papers are considered for publication based on the rigor of scientific approach, novelty, and importance for understanding mechanisms involved in the epidemiology and etiology of this disease, especially its molecular, biochemical and physiological aspects. Work relating to the clinical presentation, course, management and outcome of diabetes, including its physical and emotional sequelae, is considered. In vitro studies using animal or human tissues, whole animal and clinical studies in humans are also considered. The journal reviews full-length papers, preliminary communications with important new information, clinical reports, and reviews of major topics. Invited editorials, commentaries, and perspectives are a regular feature. The editors, based in the USA, Europe, and Australasia, maintain regular communications to assure rapid turnaround time of submitted manuscripts.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信