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      Tiempo de exposición al gluten y marcadores de riesgo de diabetes mellitus insulino dependiente en pacientes celíacos Translated title: Risk markers for insulin-dependent diabetes mellitus and duration of exposure to gluten in celiac patients

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          Background: Celiac patients are at high risk of developing insulin-dependent diabetes mellitus, a condition that has a long pre-diabetic period. During this lapse, anti-islet cell antibodies serve as markers for future disease. This may be related with the duration of the exposure to gluten. Aim: To test the hypothesis that long term adherence to a gluten free diet decreases the frequency of risk markers for insulin dependent diabetes mellitus during adolescence and early adulthood. Patients and methods: 158 celiac patients were classified as: G1, (n=30 patients) studied at the time of diagnosis; G2 (n=97 patients) exposed to gluten as a result of non compliance with the gluten free diet and, G3 (n=31 patients) who had maintained a long term, strict gluten free diet. Isotype IgG anti-islet cell antibodies were detected by indirect immunofluorescence using monkey pancreas; results were reported in Juvenile Diabetes Foundation (JDF) units. Results: Celiac patients exposed to a gluten containing diet had a significantly higher prevalence of anti-islet cell antibodies than those who had been exposed only briefly (p <0.017). In addition, a significantly higher prevalence of anti-islet cell antibodies was observed in those patients whose exposure to gluten was longer than 5 years than in those whose exposure was shorter (p <0.02). Conclusions: Celiac patients long exposed to gluten have a significantly higher prevalence of anti-islet cell antibodies than those exposed for a short period. This fact supports the hypothesis that the development of these antibodies is associated with the length of the exposure to gluten (Rev Méd Chile 2004; 132: 979-84)

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          Duration of exposure to gluten and risk for autoimmune disorders in patients with celiac disease

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            Clinical and pathological spectrum of coeliac disease--active, silent, latent, potential.

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              Quantification of islet-cell antibodies and prediction of insulin-dependent diabetes.

              The sensitivity and predictive value of islet-cell antibodies (ICA) for the future onset of insulin-dependent diabetes mellitus (IDDM) were determined in 719 first-degree relatives of IDDM patients. ICA were quantified in Juvenile Diabetes Foundation (JDF) units, by indirect immunofluorescence in serum samples taken during prospective follow-up of up to 10.5 years. The threshold of ICA detection was 4 JDF units. ICA were detected in the first sample of 26 (3.3%) of the relatives, compared with 12 (2.2%) of 540 controls (298 blood donors and 242 healthy children). ICA were detected in follow-up samples from a further 14 relatives. IDDM developed in 14 (35%) of the 40 relatives with detectable ICA at any time and in 2 (0.3%) relatives without detectable ICA. In all 5 relatives with peak ICA levels above 80 JDF units IDDM developed within follow-up of 7 years; survival without IDDM at 10 years was 27% among relatives with peak ICA levels of 20-80 JDF units and 82% for peak ICA levels of 4-20. The predictive value for IDDM development within 10 years ranged from 40% (threshold 4 JDF units) to 100% (80 JDF units) and the sensitivity from 31% (80 JDF units) to 88% (4 JDF units).
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                Author and article information

                Journal
                rmc
                Revista médica de Chile
                Rev. méd. Chile
                Sociedad Médica de Santiago (Santiago, , Chile )
                0034-9887
                August 2004
                : 132
                : 8
                : 979-984
                Affiliations
                [02] Santiago orgnameHospital Clínico Exequiel González Cortés orgdiv1Gastroenterología Pediátrica Chile
                [04] Santiago orgnameHospital San Borja Arriarán orgdiv1Unidad de Gastroenterología Pediátrica Chile
                [01] Santiago orgnameUniversidad de Chile orgdiv1Instituto de Nutrición y Tecnología de los Alimentos orgdiv2División de Nutrición Humana Chile
                [03] Santiago orgnameHospital Luis Calvo Mackenna Chile
                Article
                S0034-98872004000800010 S0034-9887(04)13200800010
                10.4067/S0034-98872004000800010
                6bbe696c-6c5b-4fb2-adb8-d772e05200a9

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 19 December 2003
                : 21 June 2004
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 17, Pages: 6
                Product

                SciELO Chile

                Categories
                ARTICULOS DE INVESTIGACION

                Prediabetic state,Diabetes mellitus, type I,Pancreatic beta cells,Gluten-sensitive enteropathy

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