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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Nagl, K; Bollow, E; Liptay, S; Rosenbauer, J; Koletzko, S; Pappa, A; Näke, A; Fröhlich-Reiterer, E; Döring, C; Wolf, J; Salfeld, P; Prinz, N.
Lower HbA1c in patients with type 1 diabetes and celiac disease who reached celiac-specific antibody-negativity-A multicenter DPV analysis.
Pediatr Diabetes. 2019; 20(8):1100-1109
Doi: 10.1111/pedi.12908
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- Co-authors Med Uni Graz
- Fröhlich-Reiterer Elke
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- 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.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent - administration & dosage
- Autoantibodies - blood
- Celiac Disease - blood, complications, immunology
- Child - administration & dosage
- Diabetes Mellitus, Type 1 - blood, complications
- Female - administration & dosage
- Glycated Hemoglobin A - metabolism
- Humans - administration & dosage
- Longitudinal Studies - administration & dosage
- Male - administration & dosage
- Find related publications in this database (Keywords)
- antibody negativity
- antibody positivity
- celiac disease
- metabolic control
- type 1 diabetes