Determination of the Frequency of Celiac and Autoimmune Thyroid Diseases in Children and Adolescents Diagnosed with Type 1 Diabetes Mellitus

Abstract

Aim: Celiac disease (CD) and autoimmune thyroid disease (AITD) are more common in individuals with Type 1 diabetes mellitus (T1DM). Hypothyroidism; has been associated with increased risk of hypoglycemia, reduced growth, and untreated CD with reduced bone mineral density has been associated with skeletal problems. It was aimed to screen the frequency of children and adolescents with T1DM in terms of CD and AITD. Material and Method: The patients diagnosed with T1DM in July 2015-March 2022 were retrospectively analyzed. The patients' age, gender, age at diagnosis, anti-TPO, anti-TG, Islet Cytoplasmic Antibodies (ICA), Insulin Autoantibodies (IAA), Glutamic Acid Decarboxylase (GADA) antibodies and accompanying autoimmune disease were investigated. Results: Chronological age was 12.5±4.4 (2.5-21.3), diagnosis of T1DM age 8.5±4.3 (1.0-17.5), duration of diabetes 4.0±3, 199 patients with T1DM aged 5 (0.0-18.1) years were included. 52.3% (n=104) of the cases were female. While the frequency of CD is 23.2% (n=10), the presence of anti-TPO and anti-TG antibodies is 6.9% (n=3) in patients whose diabetes diagnosis age is less than 5 years. Both CD and the presence of thyroid autoantibodies were more common in girls (73.3%, 68%). Conclusion: We found that the frequency of CD and AITD in our patients with T1DM was higher than in the general population, the frequency of CD increased in patients with a younger age at diagnosis of T1DM, anti-TPO antibodies was observed with advancing age at diagnosis, and both conditions were more common in females.

Keywords

• adolescent
• autoimmune thyroiditis
• celiac disease
• child
• type 1 diabetes

Tip 1 Diabetes Mellitus Tanısı Alan Çocuk ve Ergenlerde Çölyak ve Otoimmün Tiroid Hastalıkları Sıklığının Belirlenmesi

Öz

Amaç: Çölyak hastalığı (ÇH) ve otoimmün tiroid hastalığı (OTH) Tip 1 diabetes mellitus(T1DM)’lu bireylerde daha sık görülmektedir. Hipotiroidizm; hipoglisemi riskinin artması ve büyümenin azalmasıyla, tedavi edilmemiş ÇH ise azalmış kemik mineral dansitesiyle seyreden iskelet problemleriyle ilişkilendirilmiştir. Çalışmamızda T1DM tanılı çocuk ve adölesanların ÇH ve OTH açısından sıklığının taranması amaçlanmıştır. Gereç/Yöntem: Kliniğimizde Temmuz 2015- Mart 2022 arasında T1DM tanısıyla takip edilen hastaların dosyaları retrospektif olarak incelendi, hastaların yaş, cinsiyet, tanı yaşı, anti TPO, anti TG, Adacık Sitoplazmik Antikoru (ICA), İnsülin Otoantikorları (IAA), Glutamik Asit Dekarboksilaz (GADA) antikorları ve eşlik eden otoimmün hastalık varlığı araştırıldı. Bulgular: Çalışmaya takvim yaşı 12,5±4,4(2,5-21,3), T1DM tanı yaşı 8,5±4,3(1,0-17,5), diyabet süresi 4,0±3,5(0,0-18,1) yıl olan 199 T1DM’li hasta dahil edildi. Olguların %52,3’i (n=104) kız cinsiyetteydi. Diyabet tanı yaşı 5 yıldan küçük olanlarda ÇH sıklığı %23,2(n=10), anti-TPO ve anti-TG antikor varlığı %6,9(n=3) iken; 5 yıl ve üzeri olanlarda ÇH sıklığı %3,3(n=5), anti-TPO antikor varlığı %15,1(n=22), anti-TG antikor varlığı %7,1(n=10) idi. Hem ÇH, hem de tiroid otoantikor varlığının kızlarda daha sık olduğu görüldü (sırasıyla %73,3, %68). Sonuç: T1DM’li hastalarımızda literatürle uyumlu olarak ÇH ve OTH sıklığının genel popülasyona göre daha sık olduğunu, T1DM tanı yaşı küçük olanlarda ÇH sıklığın arttığını, özellikle anti-TPO antikor varlığının ilerleyen tanı yaşıyla görüldüğü, her iki durumun da kız cinsiyette daha sık olduğunu saptadık. Daha uzun süreli ve daha büyük hasta gruplarıyla yapılacak çalışmalar yeni tarama stratejilerinin geliştirilmesinde yol gösterici olacaktır.

Anahtar Kelimeler

• adölesan,
• çocuk
• çölyak hastalığı
• otoimmün tiroidit,
• tip1 diabetes mellitus

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