High Prevalence of Celiac Disease in Mexican Mestizo Adults ... : Journal of Clinical Gastroenterology (original) (raw)

ALIMENTARY TRACT: Clinical Research

High Prevalence of Celiac Disease in Mexican Mestizo Adults With Type 1 Diabetes Mellitus

Remes-Troche, José María MD*; Rios-Vaca, Aurelio MD†; Ramírez-Iglesias, María Teresa BQ*; Rubio-Tapia, Alberto MD*; Andrade-Zarate, Vicente MD†; Rodríguez-Vallejo, Fanny MD†; López-Maldonado, Francisco MD†; Gomez-Perez, Francisco Javier†; Uscanga, Luis F. MD, FACG*

Departments of *Gastroenterology

†Endocrinology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

The authors declare no conflict of interest.

The authors confirm that there is no financial arrangement with any pharmaceutical company or biomedical sponsor.

Reprints: Luis F. Uscanga, MD, Dirección de Enseñanza, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Vasco de Quiroga no. 15, Colonia Sección XVI, Tlalpan, CP 14000, México DF, México (e-mail: [email protected]).

Received for publication November 3, 2006; accepted February 7, 2007

Abstract

Background and Aims

Recent studies have shown that celiac disease (CD) could affect 0.5% to 3% of the general population, including Mexican Mestizos, which represents a complex mixture of genetics, and constitutes the core of Mexican and Latin American populations. However, the association between CD and other conditions, specifically type-1 diabetes mellitus, in this population remains unknown. Thus, our aim was to determine the prevalence of both serologic and biopsy proven CD in Mexican Mestizo adults with type-1 diabetes.

Methods

Over a 6-month period, serum samples obtained from consecutive Mexican Mestizo adult patients (age ≥18 y) with type-1 diabetes were tested with a new generation human recombinant protein based IgA tissue transglutaminase enzyme-linked immunosorbent assay commercial kit. All patients with positive serologic test results underwent upper gastrointestinal endoscopy and small intestinal biopsies to confirm CD.

Results

Eighty-four type-1 diabetic patients were included (62 women, mean age 28.9±9 y). Overall, 9 patients (9/84) were positive for IgA tissue transglutaminase with a point prevalence of 10.7% (95% CI, 4%-17%). Seven patients agreed to undergo endoscopy. Five subjects had biopsy-proven CD (5.9%, 95% CI, 1.9%-13.3%). One patient had chronic diarrhea and other abdominal bloating; whereas the remaining 3 were asymptomatic. CD associated type-1 diabetic patients tended to have higher hemoglobin A1c levels (_P_=0.07), reflecting poor glycemic control.

Conclusions

As in other populations, we demonstrated a high prevalence of biopsy-proven CD (5.9%) among Mexican Mestizo patients with type-1 diabetes. Clinicians should be aware of this common association in this ethnic group.