Performance of Celiac Serologic Markers and Follow-Up Adherence in Children with Type 1 Diabetes and Comorbid Celiac Disease
Authors' conclusion
TTG IgA ≥3.6 times ULN or positive EMA is recommended to proceed with CeD confirmation. In cases of mild TTG IgA positivity, EMA can guide CeD confirmation given its high negative predictive value.
Study context
- Population
- Children (≤18 years) diagnosed with T1D between 2000 and 2021, screened for celiac disease (CeD) after T1D diagnosis; single centre591 screened
- Participants
- 734 children
- Exposure
- T1D+CeD vs CeD-only
- Outcome
- Celiac serology diagnostic performance (TTG IgA cutoff by AUC-ROC) and CeD follow-up rates
Methodological detailssingle-centre, matched controls (age and gender at tissue transglutaminase (TTG) IgA positivity)
- Single-centre
- Matched controls (age and gender at TTG IgA positivity)
Main finding
As reported in the abstract
TTG IgA ≥3.62 times ULN for biopsy-confirmed CeD vs no CeD
| Group | Sensitivity | Specificity | PPV | NPV |
|---|---|---|---|---|
| TTG IgA ≥3.62 times upper limit of normal (ULN) | 90% | 92% | 93% | 89% |
| Endomysial antibody (EMA) | 100% | 75% | 84% | 100% |
Sensitivity
TTG IgA ≥3.62 times upper limit of normal (ULN)90%
Endomysial antibody (EMA)100%
Specificity
TTG IgA ≥3.62 times upper limit of normal (ULN)92%
Endomysial antibody (EMA)75%
PPV
TTG IgA ≥3.62 times upper limit of normal (ULN)93%
Endomysial antibody (EMA)84%
NPV
TTG IgA ≥3.62 times upper limit of normal (ULN)89%
Endomysial antibody (EMA)100%
- Positive TTG IgA among screened T1D
- 70 (11.8%)
- Confirmed CeD among TTG IgA positive
- 43 (61.4%)
Observational data: associations, not effects.
Further findings
Time to TTG IgA normalization · longer with T1D+CeD
P < 0.001
Pediatric gastroenterology CeD follow-up rate · lower with T1D+CeD
P < 0.001
Original publication
Performance of Celiac Serologic Markers and Follow-Up Adherence in Children with Type 1 Diabetes and Comorbid Celiac Disease. Horm Res Paediatr. Published 7 January 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →