Polyendocrinopathy in Children, Adolescents, and Young Adults With Type 1 Diabetes

Abstract

OBJECTIVETo investigate diabetes-specific autoantibodies and additional autoimmune phenomena in a large cohort of young patients with type 1 diabetes.RESEARCH DESIGN AND METHODSData from 28,671 patients <30 years with type 1 diabetes from 242 specialized centers in Germany and Austria were analyzed.RESULTSAt least one β-cell antibody was present in 81.6% of patients. β-cell–Ab-negative patients were significantly younger at diabetes onset (P < 0.0001). A total of 19.6% had positive thyroid antibodies with female predominance (62%, P < 0.0001). Antibodies to tissue transglutaminase were present in 10.7%, with a significantly longer duration of diabetes (P < 0.0001). Parietal cell antibodies were found in 283 patients, associated with older age (P < 0.001), and adrenal antibodies were present in 94 patients. In 575 patients, at least three different autoimmune phenomena were present.CONCLUSIONSThyroid autoimmunity and antibodies suggestive for celiac disease are the most prevalent additional immune phenomena in type 1 diabetes. Parietal/adrenal antibodies are rare.

Prevalence of Beta-Cell, Thyroid and Celiac Autoimmunity in North Indian Children with Recent Onset Type 1 Diabetes (T1D)

“…The higher prevalence of celiac autoantibodies in our patients as compared to previous studies may be explained by regional variations [11.12]. The female preponderance of anti-TPO and anti-tTGA positivity in our patients is similar to previous observations [18,19]. However, the observed sex ratio in GAD 65 positive patients was different from the previous reports [8].…”

Organ-specific autoimmunity in relation to clinical characteristics in children with long-lasting type 1 diabetes

“…The association of T1DM and AITD is highly dependent on age, sex and ethnicity [36]. Approximately 10% of T1DM patients are affected by CD with prevalence ranging from 0.6% to 16.4% reported in different studies [10,[37][38][39] and that is significantly higher than in non-diabetic children (1%-2% of the population). CD and T1DM may develop in parallel however usually T1DM precedes the onset of CD [40].…”

“…The recent extensive Ab screening study in patients with T1DM has raised awareness of the association of T1DM with organ-specific autoimmunity [29]. The reported prevalence of thyroid autoimmunity in young T1DM patients ranges between 3% and 50% [10,[30][31][32][33], while it is 3.4%-7% in the general paediatric population [34,35]. The association of T1DM and AITD is highly dependent on age, sex and ethnicity [36].…”

“…CD and T1DM may develop in parallel however usually T1DM precedes the onset of CD [40]. AD and autoimmune gastritis are less common in children with T1DM [10,41].…”

“…T1DM often occurs together with other autoimmune diseases, including autoimmune thyroid disease (AITD), celiac disease (CD) and Addison's disease (AD) [9][10][11][12]. In particular, T1DM, AITD and AD present as a clinical triad associated with autoimmune polyendocrine syndrome type II (APS type II).…”