Initial screening for celiac disease antibodies in children and adolescents with new-onset type 1 diabetes mellitus and their relationship with lipids.

Objective To initially screen children and adolescents with new-onset type 1 diabetes mellitus (T1DM) for celiac disease antibodies and to investigate the relationship between celiac disease antibodies and lipid changes. Methods This was a cross-sectional study. A total of 98 children and adolescents with newly diagnosed T1DM were recuited for the study from March 2013 to January 2021 from a single center of the Department of Pediatric Endocrinology, Metabolism and Gastroenterology at the Affiliated Hospital of Qingdao University. We collected general data [age, sex, blood pressure, incidence of diabetic ketoacidosis (DKA), etc.] and laboratory indices [lipids (triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, lipoprotein α), glycated hemoglobin A1c(HbA1c), glutamic acid decarboxylase antibody (GADA), insulin autoantibody (IAA), etc.], and calculated body mass index standard deviation score (BMI-SDS) and atherosclerosis index. We detected total serum immunoglobin A (IgA) by scattering turbidimetric method, serum anti-tissue transglutaminase antibody-IgA (tTGA-IgA) by enzyme-linked immunosorbent assay, and endomysial antibody-IgA (EMA-IgA) by indirect immunofluorescence. Based on the tTGA-IgA and EMA-IgA test results, the subjects were divided into antibody-positive group and antibody-negative group. Two independent samples t-test, Wilcoxon test, χ² test, or corrected χ² test were then performed for inter-group comparison. Results Ninety-eight children and adolescents with new-onset T1DM, aged (9.38±3.56) years, had a male-to-female ratio of 1.18:1 (53/45). There were 8 cases (8.16%) in the antibody-positive group, aged (8.07±4.12) years, with a male-to-female ratio of 3: 1 (6/2), including 2 cases positive for tTGA-IgA only, 2 cases positive for EMA-IgA only, and 4 cases positive for both tTGA-IgA and EMA-IgA. There were 90 cases (91.84%) in the antibody-negative group, aged (9.50±3.51) years, had a male-to-female ratio of 1.09: 1 (47/43). There was no significant difference between the antibody-positive and antibody-negative groups in terms of gender, age, BMI-SDS, HbA1c, the positive rates of GADA and IAA, the incidence of DKA and blood pressure (P>0.05). There was also no significant difference in triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, lipoprotein α, and atherosclerotic index between the two groups (P>0.05). Conclusions The celiac disease antibodies positive rate in children and adolescents with new-onset T1DM at our center screening was 8.16%. Although celiac disease antibodies, whether positive or negative, have no discernible impact on lipids in children and adolescents with new-onset T1DM. [ABSTRACT FROM AUTHOR]