Prevalence of celiac disease in children with type 1 diabetes mellitus screened by anti-tissue transglutaminase antibody from Western Saudi Arabia

OBJECTIVE: To determine the prevalence of celiac disease (CD) in children and adolescents with type 1 diabetes mellitus (T1DM) using anti-tissue transglutaminase (anti-tTG) antibodies.

METHODS: A retrospective hospital record-based study of all children and adolescents with T1DM who were screened for CD was conducted at the Pediatric Diabetes Clinic of King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia (KSA) between October 2002 and June 2011.

RESULTS: A total of 430 children with T1DM were screened by anti-tTG antibody. The median age at screening was 10.7 years (range; 1.1-18). The study cohort included 232 (54%) Saudi patients, and females constituted 58.8% of the total number. Anti-tTG antibody screening was positive in 91 (21.2%) patients. Forty-eight (11.2%) out of 430 children screened had biopsy-proven CD. Forty-two patients with CD (87.5%) were asymptomatic. Patients with CD had less weight for age (p=0.007), and height for age (p=0.03) z-scores than non-CD patients. They showed more association with anemia (p<0.001), low albumin level (p<0.001), and autoimmune thyroid disease (p=0.002). There was no difference in the mean glycosylated hemoglobin level (p=0.38), or insulin requirements (p=0.74) between the 2 groups.

CONCLUSION: The prevalence of CD in patients with T1DM from the Western region of KSA is considered among the highest reported. Therefore, routine screening through proper serological testing is recommended.