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Background: High prevalence rates of celiac disease (CD) in patients with type 1 diabetes (T1D) have been reported in several countries. However, the data regarding this association are scarce in Iran. In this study, we reported the prevalence of celiac disease in type 1 diabetic patients in North-West of Iran, using tissue transglutaminase antibodies (tTGA) as a screening test.
Material and methods: In this case-control study, one hundred T1D patients (58 female and 42 male) who admitted to endocrinology clinic of Tabriz Sina’s Hospital were studied. One hundred and fifty healthy people (82 female and 68 male) who randomly selected, were used as controls. All subjects were screened for the tTGA. Total IgA was obtained to investigate IgA deficient subjects. tTGA positive and IgA deficient subjects were submitted to upper gastrointestinal endoscopy.
Results: Eight T1D patients (8%) and three of the controls (2%) were positive for tTGA (P=0.023). Only 3 (3%) of the tTGA positive T1D patients underwent duodenal biopsy and all of them showed partial or total villous atrophy. The mean age of tTGA positive cases was significantly lower than tTGA negative ones (mean difference: 7.17 95%CI: 0.82-13.52). None of the tTGA positive T1D patients had a history of chronic diarrhea but 1 out of 8 tTGA positives reported history of dermatitis (P= 0.001). Also None of the tTGA positive subjects presented IgA deficiency. There was a significant difference in the history of chronic diarrhea (P= 0.006) and autoimmune diseases ( P= 0.001) between T1D patients and controls.
Conclusion: This study showed higher prevalence of CD in T1D patients than general population in North-West of Iran and the data lend support to recommend regular screening for CD in all patients with type 1 diabetes.