Association of type 1 diabetes mellitus and autoimmune disorders in Brazilian children and adolescents

Abstract

Context:Type 1 diabetes mellitus (T1DM) is caused by an immune-mediated destruction of pancreatic beta cells. Other autoimmune diseases can be observed in association with T1DM. The screening for celiac disease (CD) and Hashimoto's thyroiditis is necessary due to the increased prevalence of these pathologies in T1DM patients.Aims:This study aimed to investigate the prevalence of autoimmune markers for pancreatitis, thyroiditis, and CD in racially admixtured children and adolescents with T1DM.Settings and Design:Cross-sectional clinic-based study.Methods:Seventy-one patients with T1DM (average: 11.6 ± 5.1 years). In all patients, the following antibodies were surveyed: Anti-glutamic acid decarboxylase (anti-GAD), immunoglobulin A (IgA) anti-transglutaminase (anti-tTG), Antithyroglobulin (AAT), anti-thyroid peroxidase (anti-TPO), and IgA.Statistical Analysis Used:The quantitative variables were expressed as a mean and standard deviation and the qualitative variables in contingency tables. Student's t-test and χ2 tests were used to assess the differences between the groups. The level of significance was established as P < 0.05.Results:The prevalence of anti-GAD antibodies was 5.9%; anti-tTG IgA, 7.4%; anti-TPO, 11.8%; and AAT, 11.8%.Conclusions:Children and adolescents with T1DM have increased the prevalence of antithyroid and CD-related antibodies. The positivity for anti-GAD and antithyroid antibodies was less frequent than in other studies. The prevalence of anti-tTG antibodies was similar to the literature.

Prevalence of celiac disease in a large cohort of young patients with type 1 diabetes

“…10 Recently, another study, conducted in the northeastern region of Brazil, found a prevalence of positive IgA-tTG antibodies of 7.4%, but data of the biopsy were not informed as well. 31 These differences may be explained by genetic influences. 32,33 Brazil is a country of diverse ethnic, racial, genetic, and cultural backgrounds that includes regions with a predominance of Caucasians whereas in other regions predominate African and Native Indian descendants.…”

“…The same group carried out another study including 354 T1DM patients and found a prevalence of positive IgA‐tTG of 10.5%, but no information regarding the biopsy‐proven CD was mentioned . Recently, another study, conducted in the northeastern region of Brazil, found a prevalence of positive IgA‐tTG antibodies of 7.4%, but data of the biopsy were not informed as well …”

High prevalence of comorbid autoimmune diseases in adults with type 1 diabetes from the HealthFacts database

“…In addition to microvascular and macrovascular complications, patients with T1D incur the risk of additional autoimmune and immune deficiency diseases (collectively referred to as “autoimmune diseases” or “AID”) that further complicate their care and increase their morbidity. Although this phenomenon has been extensively studied in the pediatric population, the literature lacks sufficient epidemiological data about AID risk in older adults. The epidemiology of these AID in ethnic minorities has also not been well described.…”

Can Antioxidative Status Be Involved in Type 1 Diabetes?

“…A genetic predisposition seems to be necessary for developing the disease and is most often linked to genes in the HLA-complex [ 2 ]. Islet autoantibodies are detected in the majority of individuals at the time of diagnosis of T1DM, and these are directed against pancreatic proteins like insulin, glutamic acid decarboxylase (GAD), islet antigen 2 (IA-2), or zinc transporter 8 [ 3 ]. It is now clear that environmental factors also play a role in disease development [ 4 ].…”