Pattern of thyroid, celiac, and anti-cyclic citrullinated peptide autoantibodies coexistence with type 1 diabetes mellitus in patients from Southwestern Saudi Arabia

Abstract

Objectives:To investigate the seroprevalence of coexisting autoantibodies among type 1 diabetes mellitus (T1DM) patients, and to look for possible correlations with age at diagnosis, diabetes duration, and glycemic control.Methods:This is a cross-sectional study conducted at Aseer Central Hospital, Abha, Kingdom of Saudi Arabia from March 2013 to June 2014. A total of 202 T1DM patients were screened for serum anti-thyroglobulin (TG), anti-thyroid peroxidase (TPO), anti-tissue transglutaminase (aTTG), anti-endomysial (EMA), and anti-cyclic citrullinated peptide (anti-CCP) antibodies along with glycated hemoglobin, and biometric data.Results:From the 202 T1DM patients (96 males, and 106 females) (mean age: 11.3 years), 33 (16.3%) were positive for thyroid autoantibodies. Specifically, 19 (9.4%) were positive for TG and 25 (12.8%) were positive for TPO, and 11 were double positive. There were 21 (10.4%) patients that showed a double positive for both aTTG-IgA and EMA, and only one case of T1DM was positive for anti-CCP. No significant correlations were noticed between the presence of autoantibodies and the age at diagnosis, diabetes duration, body mass index, and glycemic control.Conclusion:The prevalence of thyroid and celiac disease autoantibodies is high among T1DM patients, while anti-CCP remains low and might be weakly associated with T1DM in the southwestern region of Saudi Arabia. No significant correlation between the age at T1DM diagnosis, duration, and glycemic control, and the presence of autoantibodies was found.

Serologic Screening of Celiac Disease in Patients With Type 1 Diabetes

“…The reported prevalence of CD in the T1DM patients from Saudi Arabia is 10% [20], while 16.4% was reported for Algeria 16.4% [21] and 11% for Iraq [22]. The difference in the prevalence of CD across geographical locations was attributed to the variations in the distribution of the HLA genotypes.…”

Type 1 Diabetes Mellitus in Saudi Arabia: A Soaring Epidemic

“…The association between T1DM and celiac disease (CD) was expected, as both the conditions include an increase in the frequency of human leukocyte antigen- (HLA-) DR3 and other HLA [ 67 – 69 ]. However, in most patients, it is often found that CD is diagnosed shortly or sometimes some year after the onset of T1DM [ 70 ].…”

“…Other studies also reported a prevalence of celiac disease in patients with T1DM in Saudi Arabia to be 4.8–11.3% [ 75 ]. Studies conducted from different regions of Saudi Arabia reported that in southern region 10.4%, in central region 11.3%, and in western region 11.2% of patients with T1DM possess celiac disease [ 67 , 69 , 75 ]. It is important to note that a recent study finding shows a high prevalence of celiac disease (19.7%) among TIDM patients in Saudi Arabia [ 51 ].…”

Celiac disease in type 1 diabetes mellitus in the Kingdom of Saudi Arabia

“…40 (7) www.smj.org.sa region (Aseer) (March 2013 and June 2014) and retrospective record based until 2018 in the Southern region (Al-Baha) ( Table 1). [10][11][12][13][14][15][16][17] The pattern of serology and biopsy. Anti-tissue transglutaminase (anti-tTG) was used in 7/8 studies; alone in 4; with anti-endomysium antibody (EMA) in 2; and with anti-gliadin antibody AGA in one.…”

“…7 In the Kingdom of Saudi Arabia, 8,9 the first study 10 concerning the CD in T1DM appeared in 2003, followed by another 7 studies, the last of which was published in 2018. [10][11][12][13][14][15][16][17] The current study represents characterization and meta-analysis for these studies concerned with CD among patients with T1DM in Kingdom of Saudi Arabia.…”