Prevalence of celiac disease in adult type 1 patients with diabetes

Celiac disease, an autoimmune disease, is related to immune mediated intolerance to gluten. Some studies suggest that Celiac Disease was 20 times more frequent in type 1 patients with diabetes. The objective of our study was to evaluate the prevalence of celiac disease in hospital based type 1 diabetic adults. Our study was carried out retrospectively in Medeniyet University Goztepe Training and Educational Hospital in Istanbul between 2012-2013. The cohort comprised 482 type 1 patients with diabetes attending the diabetes outpatient clinic. The data were analyzed by SPSS 10.5 package program. Student's t tests is used for comparative analyses. A p-value less than 0.05 was considered statistically significant. The cohort included 482 type 1 patients with diabetes. Fifty seven of them were not evaluated for Endomysium antibody positivity. Fifteen of the remaining 425 patients were positive for anti endomysial antibody [3.5%]. The prevalence of biopsy proven celiac disease was 2.3% [10/425]. There was no significant difference between Endomysial antibody positive and negative groups in regard of age, sex, or duration of the disease. This study confirms that the celiac disease is common in type 1 diabetic patients. Since a small proportion of celiac patients are symptomatic this disorder should be screened in all adult type 1 patients with diabetes by antiendomysium antibody

Relationship between uric acid levels and impaired glucose tolerance in subjects with metabolic syndrome

Metabolic syndrome [MetS] is a clustering of cardio-metabolic risk factors. Elevated serum uric acid levels are frequent in cases with cardiovascular disease carrying many attributes of MetS. The role of uric acid in the MetS pathogenesis and the development of Type 2 Diabetes Mellitus [DM] was not fully understood. In this study, the relationship between serum uric acid levels and MetS criteria and oral glucose tolerance test [OGTT] results was studied. This study was carried out in 83 patients having at least three MetS diagnosis criteria recommended by National Cholesterol Education Program Adult Treatment Panel III. After collecting 12-hour fasting venous blood samples of subjects, 2-hour OGTT was performed with 75 g oral glucose. A glucose level between 140 and 199 mg/dl at hour 2 was defined as impaired glucose tolerance. The 2-hour glucose value of 25 cases [31%] out of 83 cases was determined to be 140 mg/dl and over. In the multiple linear regression analysis, it was found that uric acid level and waist circumference, and body mass index and 2-hour OGTT levels were significantly related. In this study, in cases having high risk for type 2 DM, it was found that uric acid levels were related by some MetS components. Uric acid concentrations did not effect basal glycemia and insulin sensitivity

Metabolic syndrome frequency in inflammatory bowel diseases

Metabolic syndrome [MetS] is a clinical condition characterized by central obesity, elevated triglycerides, low-high density lipoproteins, impaired fasting glucose, and hypertension. There is insufficient data on the prevalence of MetS in patients with inflammatory bowel disease [IBD]. This study sought to determine the prevalence of MetS in a Turkish cohort of patients with IBD and the association between insulin resistance [IR] and the MetS parameters, in this population. A total of 177 patients over 18 years of age [62 with Crohn's disease [CD] and 115 with ulcerative colitis [UC]] were enrolled in the study. The presence of at least three criteria of the International Diabetes Federation [IDF] was accepted for the diagnosis of MetS. The Homeostasis Model Assessment [HOMA] was used to determine IR. HOMA values < 1 were considered normal and values > 2.5 indicated a high probability of IR. MetS frequency was higher in patients n=34 [29.5%] with UC than in patients n=11 [17.7%] with CD [P < 0.01]. MetS was detected in 12 of the 117 patients [10.3%] with IBD, under 45 years of age, and in 33 of 60 patients [55%] over 45 years of age. HOMA value in n=31 patients [27%] with UC was > 2.5. Body mass index, insulin [P < 0.001], waist circumference, fasting plasma glucose, leukocyte count [P < 0.01], triglycerides, C-reactive protein, and uric acid values [P < 0.05] were significantly higher in UC patients with IR than those without IR. Frequent occurrence of MS with increasing age in IBD, particularly in UC, showed the importance of early diagnosis and treatment of cardiovascular disease risk factors in the long-term follow-up of these diseases