CELIAC AND AUTOIMMUNE THYROID DISEASE IN PATIENTS WITH ANTI-GAD POSITIVE TYPE-1 DIABETES MELLITUS
DOI:
https://doi.org/10.55519/JAMC-03-12011Keywords:
Anti-GAD antibodies, Anti-thyroid antibodies, Celiac disease, HbA1c, Type-1 diabetes mellitusAbstract
Background: Type-1 diabetes mellitus (T1DM) and autoimmune thyroid disease can occur concomitantly and patients with TIDM have a high risk of other autoimmune conditions like thyroid disease and celiac disease. This study aimed to analyze the association of anti-GAD positive T1DM with anti-thyroid antibodies and celiac disease. Methods: This cross-sectional study was conducted at the Department of Paediatric Endocrinology & Diabetes, National Institute of Child Health, Karachi Pakistan from July 2022 to December 2022. A total of 115 children of both genders aged between 1-18 years having known T1DM were analyzed. Children with chronic kidney disease or chronic liver disease were excluded. Those children were also not included whose parents/caregivers did not wish their children to be part of this research. The blood sample of each child was taken in a sterilized container and sent to an institutional laboratory for biochemical investigations. Results: In a total of 115 patients, 67 (58.3%) were female and 48 (41.7%) males. The mean age was 8.87±3.43 (ranging between 1.5-17 years). The mean HbA1c was 11.86±7.31%. It was found that anti-GAD IgG was having signification association with celiac disease (p<0.001). Significant correlation of anti-GAD positive antibodies with Ttg-IgG antibodies (correlation coefficient=0.303, p=0.001), thyroid peroxidase antibodies (correlation coefficient=0.228, p=0.001). Conclusion: High proportions of children with anti-GAD positive T1DM patients were found to have thyroid disorders and celiac disease. A significant correlation was found between anti-GAD positive antibodies, celiac disease and anti-thyroglobulin antibodies.
References
Orzan A, Novac C, Mihaiela MI, Tirgoviste CI, Balgradean M. Type 1 diabetes and thyroid autoimmunity in children. Maedica 2016;11(4):308.
Gul K, Ustun I, Aydin Y, Berker D, Erol HK, Unal M, et al. Autoimmune thyroid disease in patients with anti-GAD positive type 1 diabetes mellitus. Cent Eur J Med 2009;4(4):415-22.
Kakleas K, Paschali E, Kefalas N, Fotinou A, Kanariou M, Karayianni C, et al. Factors for thyroid autoimmunity in children and adolescents with type 1 diabetes mellitus. Ups J Med Sci 2009;114(4):214-20.
Li L, Liu S, Yu J. Autoimmune thyroid disease and type 1 diabetes mellitus: same pathogenesis; new perspective? Ther Adv Endocrinol Metab 2020;11:2042018820958329.
Kawasaki E. Type 1 diabetes and autoimmunity. Clin Pediatr Endocrinol 2014;23(4):99-105.
Karuranga S, Fernandes JDR, Huang Y, Malanda B. IDF Diabetes Atlas. 8th ed. International Diabetes Federation; 2018.
Oyenusi EE, Ajayi EO, Akeredolu FD, Oduwole AO. Pattern of thyroid disorders in children and adolescents seen at the Lagos university teaching hospital, Nigeria, over a 10-year period. Niger Med J 2017;58(3):101-6.
Leung AKC, Leung AAC. Evaluation and management of the child with hypothyroidism. World J Pediatr 2019;15(2):124-34.
Krzewska A, Ben-Skowronek I. Effect of associated autoimmune diseases on type 1 diabetes mellitus incidence and metabolic control in children and adolescents. BioMed Res Int 2016;2016:6219730.
Fatourechi A, Ardakani HM, Sayarifard F, Sheikh M. Hypothyroidism among pediatric patients with type 1 diabetes mellitus, from patients' characteristics to disease severity. Clin Pediatr Endocrinol 2017;26(2):73-80.
Léger J, Carel JC. Hyperthyroidism in childhood: causes, when and how to treat. J Clin Res Pediatr Endocrinol 2013;5(Suppl 1):50-6.
Bhadada SK, Kochhar R, Bhansali A, Dutta U, Kumar PR, Poornachandra KS, et al. Prevalence and clinical profile of celiac disease in type 1 diabetes mellitus in north India. J Gastroenterol Hepatol 2011;26(2):378-81.
Agrawal RP, Rathore A, Joshi A, Changal H, Kochar DK. Prevalence of celiac disease in type 1 diabetes mellitus in North West Rajasthan, India. Diabetes Res Clin Pract 2008;79(1):e15-6.
Walker-Smith JA, Grigor W. CÅ“liac disease in a diabetic child. Lancet 1969;293(7603):1021.
Pulikkal AA, Kolly A, Kumar KP, Shivaprasad C. The seroprevalence of immunoglobulin A transglutaminase in type 1 diabetic patients of South Indian origin. Ind J Endocrinol Metabol 2016;20(2):233-7.
Sharma B, Nehara HR, Saran S, Bhavi VK, Singh AK, Mathur SK. Coexistence of autoimmune disorders and type 1 diabetes mellitus in children: an observation from western part of India. Indian J Endocrinol Metab 2019;23(1):22-6.
Marwaha RK, Garg MK, Tandon N, Kanwar R, Narang A, Sastry A, et al. Glutamic acid decarboxylase (anti-GAD) & tissue transglutaminase (anti-TTG) antibodies in patients with thyroid autoimmunity. Indian J Med Res 2013;137(1):82.
Basu M, Pandit K, Banerjee M, Mondal SA, Mukhopadhyay P, Ghosh S. Profile of auto-antibodies (Disease related and other) in children with type 1 diabetes. Indian J Endocrinol Metab 2020;24(3):256-9.
Riseh SH, Farhang MA, Mobasseri M, Jafarabadi MA. The Relationship between Thyroid Hormones, Antithyroid Antibodies, Anti-Tissue Transglutaminase and Anti-Gliadin Antibodies in Patients with Hashimoto's Thyroiditis. Acta Endocrinol (Buchar) 2017;13(2):174-9.
Oujamaa I, Sebbani M, Elmoumou L, Bourrahouate A, El Qadiry R, El Moussaoui S, et al. The Prevalence of Celiac Disease-Specific Auto-Antibodies in Type 1 Diabetes in a Moroccan Population. Int J Endocrinol 2019;2019:7895207.
Umpierrez GE, Latif KA, Murphy MB, Lambeth HC, Stentz F, Bush A, et al. Thyroid dysfunction in patients with type 1 diabetes: a longitudinal study. Diabetes Care 2003;26(4):1181-5.
Hansen D, Bennedbaek FN, Høier-Madsen M, Hegedüs L, Jacobsen BB. A prospective study of thyroid function, morphology and autoimmunity in young patients with type 1 diabetes. Eur J Endocrinol 2003;148(2):245-51.
Holl RW, Bohm B, Loos U, Grabert M, Heinze E, Homoki J. Thyroid autoimmunity in children and adolescents with type 1 diabetes mellitus. Effect of age, gender and HLA type. Horm Res 1999;52(3):113-8.
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