Celiac disease in type 1 diabetes melittus in a North American community: Prevalence, serologic screening, and clinical features

Farid H. Mahmud, Joseph A Murray, Yogish C Kudva, Alan R. Zinsmeister, Ross A. Dierkhising, Brian D. Lahr, Peter J Dyck, Robert A. Kyle, Mounif El-Youssef, Lawrence J. Burgart, Carol T. Van Dyke, Deanna L. Brogan, L. Joseph Melton

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Abstract

OBJECTIVES: To estimate the prevalence of celiac disease (CD) in pediatric and adult type 1 diabetes mellitus in a defined population and to describe clinical features and HLA class II genotypes predictive of CD in screened patients with type 1 diabetes. PATIENTS AND METHODS: All residents of Olmsted County, Minnesota, with type 1 diabetes mellitus on the prevalence date January 1, 2001, were identified with the use of an established medical records linkage system (Rochester Epidemiology Project) and defined clinical criteria. Consenting patients underwent serologic screaming with endomysial antibody and tissue transglutaminase antibody testing and intestinal biopsies to confirm the diagnosis of CD. A subset of screened patients also underwent HLA class II genotyping. Quality-of-life screening (Medical Outcomes Study 36-Item Short-Form Health Survey) was completed in a subset of patients at the time of serologic screening. RESULTS: Overall, 332 Olmsted County residents with type 1 diabetes on January 1, 2001, were identified. A total of 158 patients with type 1 diabetes were tested, representing 40% (158/392) of the enumerated diabetic population, and 11 had biopsy-proven CD for an estimated point prevalence of 7.0% (95% confidence interval, 3.5%-12.1%). Most CD-positive diabetic patients were asymptomatic and expressed an at-risk CD haplotype with at least one of but not both HLA DQ2 or DQ8. CONCLUSIONS: Celiac disease is not rare in North American patients with type 1 diabetes, and most CD-positive diabetic patients are asymptomatic irrespective of age at screening.

Original languageEnglish (US)
Pages (from-to)1429-1434
Number of pages6
JournalMayo Clinic Proceedings
Volume80
Issue number11
StatePublished - 2005

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Celiac Disease
Type 1 Diabetes Mellitus
Medical Record Linkage
Biopsy
Antibodies
Health Surveys
Haplotypes
Population
Epidemiology
Genotype
Quality of Life
Outcome Assessment (Health Care)
Confidence Intervals
Pediatrics

ASJC Scopus subject areas

  • Medicine(all)

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Celiac disease in type 1 diabetes melittus in a North American community : Prevalence, serologic screening, and clinical features. / Mahmud, Farid H.; Murray, Joseph A; Kudva, Yogish C; Zinsmeister, Alan R.; Dierkhising, Ross A.; Lahr, Brian D.; Dyck, Peter J; Kyle, Robert A.; El-Youssef, Mounif; Burgart, Lawrence J.; Van Dyke, Carol T.; Brogan, Deanna L.; Melton, L. Joseph.

In: Mayo Clinic Proceedings, Vol. 80, No. 11, 2005, p. 1429-1434.

Research output: Contribution to journalArticle

Mahmud, FH, Murray, JA, Kudva, YC, Zinsmeister, AR, Dierkhising, RA, Lahr, BD, Dyck, PJ, Kyle, RA, El-Youssef, M, Burgart, LJ, Van Dyke, CT, Brogan, DL & Melton, LJ 2005, 'Celiac disease in type 1 diabetes melittus in a North American community: Prevalence, serologic screening, and clinical features', Mayo Clinic Proceedings, vol. 80, no. 11, pp. 1429-1434.
Mahmud, Farid H. ; Murray, Joseph A ; Kudva, Yogish C ; Zinsmeister, Alan R. ; Dierkhising, Ross A. ; Lahr, Brian D. ; Dyck, Peter J ; Kyle, Robert A. ; El-Youssef, Mounif ; Burgart, Lawrence J. ; Van Dyke, Carol T. ; Brogan, Deanna L. ; Melton, L. Joseph. / Celiac disease in type 1 diabetes melittus in a North American community : Prevalence, serologic screening, and clinical features. In: Mayo Clinic Proceedings. 2005 ; Vol. 80, No. 11. pp. 1429-1434.
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T1 - Celiac disease in type 1 diabetes melittus in a North American community

T2 - Prevalence, serologic screening, and clinical features

AU - Mahmud, Farid H.

AU - Murray, Joseph A

AU - Kudva, Yogish C

AU - Zinsmeister, Alan R.

AU - Dierkhising, Ross A.

AU - Lahr, Brian D.

AU - Dyck, Peter J

AU - Kyle, Robert A.

AU - El-Youssef, Mounif

AU - Burgart, Lawrence J.

AU - Van Dyke, Carol T.

AU - Brogan, Deanna L.

AU - Melton, L. Joseph

PY - 2005

Y1 - 2005

N2 - OBJECTIVES: To estimate the prevalence of celiac disease (CD) in pediatric and adult type 1 diabetes mellitus in a defined population and to describe clinical features and HLA class II genotypes predictive of CD in screened patients with type 1 diabetes. PATIENTS AND METHODS: All residents of Olmsted County, Minnesota, with type 1 diabetes mellitus on the prevalence date January 1, 2001, were identified with the use of an established medical records linkage system (Rochester Epidemiology Project) and defined clinical criteria. Consenting patients underwent serologic screaming with endomysial antibody and tissue transglutaminase antibody testing and intestinal biopsies to confirm the diagnosis of CD. A subset of screened patients also underwent HLA class II genotyping. Quality-of-life screening (Medical Outcomes Study 36-Item Short-Form Health Survey) was completed in a subset of patients at the time of serologic screening. RESULTS: Overall, 332 Olmsted County residents with type 1 diabetes on January 1, 2001, were identified. A total of 158 patients with type 1 diabetes were tested, representing 40% (158/392) of the enumerated diabetic population, and 11 had biopsy-proven CD for an estimated point prevalence of 7.0% (95% confidence interval, 3.5%-12.1%). Most CD-positive diabetic patients were asymptomatic and expressed an at-risk CD haplotype with at least one of but not both HLA DQ2 or DQ8. CONCLUSIONS: Celiac disease is not rare in North American patients with type 1 diabetes, and most CD-positive diabetic patients are asymptomatic irrespective of age at screening.

AB - OBJECTIVES: To estimate the prevalence of celiac disease (CD) in pediatric and adult type 1 diabetes mellitus in a defined population and to describe clinical features and HLA class II genotypes predictive of CD in screened patients with type 1 diabetes. PATIENTS AND METHODS: All residents of Olmsted County, Minnesota, with type 1 diabetes mellitus on the prevalence date January 1, 2001, were identified with the use of an established medical records linkage system (Rochester Epidemiology Project) and defined clinical criteria. Consenting patients underwent serologic screaming with endomysial antibody and tissue transglutaminase antibody testing and intestinal biopsies to confirm the diagnosis of CD. A subset of screened patients also underwent HLA class II genotyping. Quality-of-life screening (Medical Outcomes Study 36-Item Short-Form Health Survey) was completed in a subset of patients at the time of serologic screening. RESULTS: Overall, 332 Olmsted County residents with type 1 diabetes on January 1, 2001, were identified. A total of 158 patients with type 1 diabetes were tested, representing 40% (158/392) of the enumerated diabetic population, and 11 had biopsy-proven CD for an estimated point prevalence of 7.0% (95% confidence interval, 3.5%-12.1%). Most CD-positive diabetic patients were asymptomatic and expressed an at-risk CD haplotype with at least one of but not both HLA DQ2 or DQ8. CONCLUSIONS: Celiac disease is not rare in North American patients with type 1 diabetes, and most CD-positive diabetic patients are asymptomatic irrespective of age at screening.

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