Lower HbA1c in patients with type 1 diabetes and celiac disease who reached celiac-specific antibody-negativity-A multicenter DPV analysis.
antibody negativity
antibody positivity
celiac disease
metabolic control
type 1 diabetes
Journal
Pediatric diabetes
ISSN: 1399-5448
Titre abrégé: Pediatr Diabetes
Pays: Denmark
ID NLM: 100939345
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
24
04
2019
revised:
28
06
2019
accepted:
13
08
2019
pubmed:
21
8
2019
medline:
2
7
2020
entrez:
21
8
2019
Statut:
ppublish
Résumé
To study celiac-specific antibody status over 3 years in patients with type 1 diabetes and biopsy-proven celiac disease (T1D + CD). Furthermore, to determine clinical differences after diagnosis between patients reaching constant antibody-negativity (Ab-neg) and staying antibody-positive (Ab-pos). A total of 608 pediatric T1D + CD patients from the multicenter DPV registry were studied longitudinally regarding their CD specific antibody-status. Differences between Ab-neg (n = 218) and Ab-pos (n = 158) patients 3 years after biopsy were assessed and compared with 26 833 T1D patients without CD by linear and logistic regression adjusted for age, gender, diabetes duration and migration background. Thirty-six percent of T1D + CD patients reached and sustained antibody-negativity 3 years after CD diagnosis. The median time until patients returned to Ab-neg was 0.86 (0.51;1.16) years. Three years after diagnosis, HbA1c was lowest in Ab-neg and highest in Ab-pos patients compared to T1D-only patients (adjusted mean (95%CI): 7.72 (7.51-7.92) % vs 8.44 (8.20-8.68) % vs 8.19 (8.17-8.21) %, adjusted P < 0.001, respectively). Total cholesterol, LDL-cholesterol and frequency of dyslipidemia were significantly lower in Ab-neg compared to T1D-only patients (167 (161-173) mg/dl vs 179 (178-179) mg/dl, P < .001; 90 (84-96) mg/dl vs 99 (98-99) mg/dl, P = .005; 15.7 (10.5-22.9) % vs 25.9 (25.2-26.6) %, P = .017). In longitudinal analyses over 6 years after diagnosis, a constantly higher HbA1c (P < .001) and a lower height-SDS (P = .044) was observed in Ab-pos compared to Ab-neg patients. Only one third of T1D + CD patients reached constant Ab-negativity after CD diagnosis. Achieving Ab-negativity after diagnosis seems to be associated with better metabolic control and growth, supposedly due to a higher adherence to therapy in general.
Identifiants
pubmed: 31430021
doi: 10.1111/pedi.12908
pmc: PMC6899993
doi:
Substances chimiques
Autoantibodies
0
Glycated Hemoglobin A
0
hemoglobin A1c protein, human
0
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1100-1109Informations de copyright
© 2019 The Authors. Pediatric Diabetes published by John Wiley & Sons Ltd.
Références
J Pediatr Gastroenterol Nutr. 2017 Sep;65(3):267-269
pubmed: 28489675
World J Diabetes. 2013 Aug 15;4(4):130-4
pubmed: 23961323
Diabetes Care. 2013 Feb;36(2):316-21
pubmed: 22966098
Diabetes Care. 2016 Aug;39(8):e119-20
pubmed: 27271186
Pediatr Diabetes. 2013 Sep;14(6):455-8
pubmed: 23763501
Clin Exp Immunol. 2015 Feb;179(2):230-5
pubmed: 25212572
Pediatr Diabetes. 2016 May;17(3):191-8
pubmed: 25677756
Diabetes Care. 2015 May;38(5):760-6
pubmed: 25784659
Arch Dis Child. 2004 Sep;89(9):871-6
pubmed: 15321869
Eur J Clin Nutr. 2010 Apr;64(4):341-9
pubmed: 20179728
Stat Med. 1992 Jul;11(10):1305-19
pubmed: 1518992
Acta Diabetol. 2013 Aug;50(4):497-503
pubmed: 21691748
Acta Diabetol. 2017 Oct;54(10):889-894
pubmed: 28639064
Arch Dis Child. 2019 Apr;104(4):354-359
pubmed: 30327331
J Pediatr. 2011 Feb;158(2):276-81.e1
pubmed: 20817171
Diabetes Care. 2015 May;38(5):801-7
pubmed: 25690004
Pediatr Diabetes. 2019 Dec;20(8):1100-1109
pubmed: 31430021
J Pediatr Gastroenterol Nutr. 2012 Jan;54(1):136-60
pubmed: 22197856
Clin Gastroenterol Hepatol. 2011 Feb;9(2):118-23
pubmed: 21029791
J Diabetes Sci Technol. 2016 Aug 22;10(5):1042-9
pubmed: 27381028
J Pediatr. 2016 Dec;179:131-138.e1
pubmed: 27720243
Gastroenterology. 2014 Sep;147(3):610-617.e1
pubmed: 24837306
J Pediatr. 2011 Apr;158(4):589-593.e2
pubmed: 21051047
Pediatr Diabetes. 2018 Nov;19(7):1271-1275
pubmed: 29923262
Pediatr Diabetes. 2017 Dec;18(8):874-882
pubmed: 28117539
Pediatr Diabetes. 2018 Oct;19 Suppl 27:275-286
pubmed: 30066458
Diabetes Care. 2012 Jan;35(1):80-6
pubmed: 22074726
Eur J Gastroenterol Hepatol. 2015 Oct;27(10):1193-9
pubmed: 26181110
Diabetes Care. 2017 Aug;40(8):1034-1040
pubmed: 28546222
Sci Rep. 2017 Mar 24;7:45286
pubmed: 28338063
Dig Dis Sci. 2008 May;53(5):1240-5
pubmed: 17939041
Arch Dis Child. 2014 Aug;99(8):738-43
pubmed: 24812301
Aliment Pharmacol Ther. 2009 May 15;29(10):1131-6
pubmed: 19245681
Diabetes Care. 2006 Nov;29(11):2452-6
pubmed: 17065683
Acta Diabetol. 2015 Dec;52(6):1167-74
pubmed: 26403595