مقايسه ميزان فراواني سلياك در بيماران ديابتيك نوع يك با افراد غيرديابتيك سالم

COMPARING FREQUENCY OF CELIAC DISEASE IN PATIENTS WITH DIABETES MELLITUS TYPE I AND NON-DIABETIC , HEALTHY PERSONS

Background :Several studies and research have shown a higher prevalence of celiac disease (CD) and elevation of serum antibody (AGA-IgA & IgA-tTG & EMA-IgA ) in patient with diabetes mellitus type I (T1DM) in versus general and non-diabetic population. Thus screening of CD is recommended in T1DM). This study was conducted to compare frequency of celiac disease in patients with T1DM and healthy persons. Methods: As a case-control study,60 patient with T1DM that reffered to endocrine clinic of Qazvinʹs Boo-Ali hospital , in nearly one year period were enrolled as case group. 60 non-diabetic healthy subjects with age and sex matched, were selected as control group. Blood levels of Total IgA, AGA-IgA and IgA-tTG were measured in all of them, subjects who had elevated of both AGA-IgA and IgA-tTG underwent an upper GI endoscopy and biopsy was done from distal part of duodenum. Results: Any one in case group hadnʹt IgA deficiency. 14 subjects in control and 12 subjects in case group had positive AGA-IgA that there was no significant difference between them . 2 subject of case group had positive IgA-tTG. Duodenal biopsy in 1 of 14 cases who had elevated AGA-IgA( 1 of 2 cases who had elevated IgA-tTG) , revealed total villous atrophy indicating CD (Type III: with revised Marsh criteria 2001) and in other cases pathologic findings were normal or with nonspecific changes. Conclusion: Frequency of CD in T1DM in our study is 1.67%. There is not any significant difference between case and control groups in prevalence of Celiac disease . But we conclused that screening with AGA-IgA is not a reliable screening test for CD , because there is not significant difference between TIDM and general population .