Journal
DIABETES CARE
Volume 33, Issue 4, Pages 774-779Publisher
AMER DIABETES ASSOC
DOI: 10.2337/dc09-1217
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Funding
- Juvenile Diabetes Research Foundation International [4-1999-731, 4-2001-435, 1-2006-896, 36-2008-925]
- Sigrid Juselius Foundation
- Academy of Finland
- Paivikki and Sakari Sohlberg Foundation
- Novo Nordisk Foundation
- Jalmari and Rauha Ahokas Foundation
- Foundation for Pediatric Research, Finland
- Foundation for Diabetes Research, Finland
- Signe and Ane Gyllenberg Foundation
- Turku University Foundation
- Celiac Disease Association, Finland
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OBJECTIVE - To compare the ages and sequence in which antibodies associated with type 1 diabetes and celiac disease appear and overt diseases develop in children with an HLA-conferred susceptibility to both diseases. RESEARCH DESIGN AND METHODS - We observed 2,052 children carrying genetic risks for both type 1 diabetes and celiac disease from birth until the median age of 5.7 years and analyzed diabetes- and celiac disease associated antibodies in serum samples collected at 3- to 12-month intervals. Diabetes was confirmed by World Health Organization criteria and celiac disease by duodenal biopsies. RESULTS - Altogether 342 children seroconverted to positivity for at least one diabetes-associated autoantibody and 88 to positivity for at least one celiac disease associated antibody at the median ages of 3.0 and 1.5 years, respectively (P < 0.001). If only children with biochemically defined diabetes-associated autoantibodies against insulin, GAD, or IA-2A protein (n = 146) and children with tissue transglutaminase autoantibodies were compared (n = 86), the median seroconversion ages were 2.5 and 3.0 years (P = 0.011). Fifty-one children progressed to overt diabetes at 4.5 years and 44 children to celiac disease at 4.3 years (P = 0.257). Of the 19 children who developed both diabetes- and celiac disease associated antibodies, 3 progressed to both diabetes and celiac disease. CONCLUSIONS - Children with HLA-conferred susceptibility to type 1 diabetes and celiac disease develop celiac disease associated antibodies mostly at a younger age or the same age at which they develop diabetes-associated autoantibodies. Clinical diabetes and celiac disease are commonly diagnosed at the same median age.
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