Login
- Titel:
Lower HbA1c in patients with type 1 diabetes and celiac disease who reached celiac-specific antibody-negativity-A multicenter DPV analysis.
- Dokumenttyp:
- Article; Journal Article; Research Support, Non-U.S. Gov't
- Autor(en):
- Nagl, Katrin; Bollow, Esther; Liptay, Susanne; Rosenbauer, Joachim; Koletzko, Sibylle; Pappa, Angeliki; Näke, Andrea; Fröhlich-Reiterer, Elke; Döring, Christian; Wolf, Johannes; Salfeld, Peter; Prinz, Nicole
- Abstract:
- OBJECTIVES: 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). METHODS: 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. RESULTS: 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. CONCLUSION: 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.
- Zeitschriftentitel:
- Pediatr Diabetes
- Jahr:
- 2019
- Band / Volume:
- 20
- Heft / Issue:
- 8
- Seitenangaben Beitrag:
- 1100-1109
- Volltext / DOI:
- doi:10.1111/pedi.12908
- PubMed:
- http://view.ncbi.nlm.nih.gov/pubmed/31430021
- Print-ISSN:
- 1399-543X
- TUM Einrichtung:
- Klinik und Poliklinik für Kinderheilkunde und Jugendmedizin
BibTeX