Antibodies Are Predictive for Diagnosis of Celiac Disease in Pediatric Type 1 Diabetes
Authors' conclusion
Our results suggest an indication for biopsy for CD confirmation at a TGA-IgA cutoff around 6.1 × upper limit of normal. Including IgG antibodies against deamidated gliadin peptides can potentially increase precision. TGA-IgA determination at T1D diagnosis may help to identify individuals at risk of CD early on.
Study context
- Population
- Pediatric T1D individuals diagnosed at 2 centers in Switzerland, 2000–2021, followed from T1D diagnosis to celiac disease (CD) diagnosis or age 18 years2,944 TGA-IgA values
- Participants
- 588 individuals
- Exposure
- TGA-IgA vs Inclusion of IgG antibodies against deamidated gliadin peptides
- Outcome
- Optimal TGA-IgA cutoff for performing diagnostic biopsies for CD confirmation
Methodological details2 centres, retrospective longitudinal analysis
- 2 centres
- Retrospective longitudinal analysis
Main finding
As reported in the abstract
Biopsy indication for CD
| Group | AUC | Best cutoff (balancing sensitivity and specificity) | Accuracy |
|---|---|---|---|
| TGA-IgA | — not stated in the abstract | around 6.1 × upper limit of normal | — not stated in the abstract |
| TGA-IgA + DGP-IgG | 0.79 (95% CI, 0.6-1) | — not stated in the abstract | 80% |
AUC
TGA-IgA— not stated in the abstract
TGA-IgA + DGP-IgG0.79 (95% CI, 0.6-1)
Best cutoff (balancing sensitivity and specificity)
TGA-IgAaround 6.1 × upper limit of normal
TGA-IgA + DGP-IgG— not stated in the abstract
Accuracy
TGA-IgA— not stated in the abstract
TGA-IgA + DGP-IgG80%
— not stated in the abstract
Observational data: associations, not effects.
Further findings
CD incidence during follow-up
- Developed CD
- 34 (5.8%)
- CD-associated symptoms at CD diagnosis
- 50%
TGA-IgA evolution and timing of CD diagnosis
- CD diagnosis within 2 years of T1D (two thirds of CD) marked by elevated TGA-IgA at T1D diagnosis
- Later CD diagnosis associated with more gradual increase of TGA-IgA
Original publication
Antibodies Are Predictive for Diagnosis of Celiac Disease in Pediatric Type 1 Diabetes. J Clin Endocrinol Metab. Published 8 March 2025. doi:10.
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