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Whole lipid profile and not only HDL cholesterol is impaired in children with coexisting type 1 diabetes and untreated celiac disease

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Abstract

Aims

Low HDL cholesterol (HDL-C) levels have been described in patients with coexisting type 1 diabetes mellitus (T1DM) and celiac disease (CD). Data on other possible lipid abnormalities that could further increase cardiovascular risk in these patients are scarce and incomplete. Aim of this retrospective multicenter study was to evaluate whole lipid profiles, besides HDL-C, in children with T1DM associated with biopsy-proven CD, and to investigate the influence of age and degree of adherence to gluten-free diet (GFD) on lipid changes.

Methods

A total of 261 children with both T1DM and CD were enrolled. Serum lipid profiles at CD diagnosis were compared with those after 1 year of GFD and with those of 224 matched children with T1DM alone. The adherence to GFD was judged by means of CD-related antibodies.

Results

At CD diagnosis, children with T1DM + CD showed higher LDL cholesterol (LDL-C) compared to children with T1DM alone. Gluten withdrawal failed to normalize LDL-C levels, not even in completely adherent individuals. HbA1c values were not influenced by GFD. The youngest children were characterized at diagnosis by lower levels of total cholesterol and on treatment by a greater decrease in triglycerides levels.

Conclusions

An unfavorable lipid profile, characterized not only by low HDL-C levels but also by high LDL-C values, may increase the risk of cardiovascular disease in children with T1DM and untreated CD. Therefore, a strict gluten-free diet is mandatory in these children, especially the youngest.

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References

  1. Pitocco D, Giubilato S, Martini F et al (2011) Combined atherogenic effects of celiac disease and type 1 diabetes mellitus. Atherosclerosis 217:531–535

    Article  CAS  PubMed  Google Scholar 

  2. Mollazadegan K, Kugelberg M, Montgomery SM, Sanders DS, Ludvigsson J, Ludvigsson JF (2013) A population-based study of the risk of diabetic retinopathy in patients with type 1 diabetes and celiac disease. Diabetes Care 36:316–321

    Article  PubMed  PubMed Central  Google Scholar 

  3. Pham-Short A, Donague KC, Ambler G et al (2014) Early elevation of albumin excretion rate is associated with poor gluten-free diet adherence in young people with coeliac disease and diabetes. Diabet Med 31:208–212

    Article  CAS  PubMed  Google Scholar 

  4. Roher TR, Wolf J, Liptay S et al (2015) Microvascular complications in childhood-onset type 1 diabetes and celiac disease: a multicenter longitudinal analysis of 56,514 patients from the German–Austrian DPV Database. Diabetes Care 38:801–807

    Article  Google Scholar 

  5. Bakker SF, Tushuizen ME, von Blomberg ME, Mulder CJ, Simsek S (2013) Type 1 diabetes and celiac disease in adults: glycemic control and diabetic complications. Acta Diabetol 50:319–324

    Article  CAS  PubMed  Google Scholar 

  6. Gopee E, van den Oever ELM, Cameron F, Thomas MC (2013) Coeliac disease, gluten-free diet and the development and progression of albuminuria in children with type 1 diabetes. Pediatr Diabetes 14:455–458

    Article  CAS  PubMed  Google Scholar 

  7. Picarelli A, Di Tola M, Sabbatella L et al (2013) Type 1 diabetes mellitus and celiac disease: endothelial dysfunction. Acta Diabetol 50:497–503

    Article  CAS  PubMed  Google Scholar 

  8. Leeds JS, Hopper AD, Hadjivassiliou M, Tesfaye S, Sanders DS (2011) High prevalence of microvascular complications in adults with type 1 diabetes and newly diagnosed celiac disease. Diabetes Care 34:2158–2163

    Article  PubMed  PubMed Central  Google Scholar 

  9. Jessup AB, Law JR, Spagnoli A (2014) Are HDL levels lower in children with type 1 diabetes and concurrent celiac disease compared with children with type 1 diabetes only? J Pediatr Endocrinol Metab 27:1213–1216

    CAS  PubMed  Google Scholar 

  10. Warncke K, Liptay S, Fröhlih-Reiterer E et al (2015) Vascular risk factors in children, adolescents and young adults with type 1 diabetes complicated by celiac disease: results from the DPV initiative. Pediatr Diabetes. doi:10.1111/pedi.1226

    PubMed  Google Scholar 

  11. Salardi S, Maltoni G, Zucchini S et al (2016) Celiac disease negatively influences lipid profiles in young children with type 1 diabetes: effect of the gluten-free diet. Diabetes Care 39:e119–e120

    Article  PubMed  Google Scholar 

  12. Lewis NR, Sanders DS, Logan RF, Fleming KM, Hubbard RB, West J (2009) Cholesterol profile in people with newly diagnosed coeliac disease: a comparison with the general population and changes following treatment. Br J Nutr 102(509):513

    Google Scholar 

  13. Brar P, Kwon GY, Holleran S et al (2006) Change in lipid profile in celiac disease: beneficial effect of gluten-free diet. Am J Med 119:786–790

    Article  CAS  PubMed  Google Scholar 

  14. De Marchi S, Chiarioni G, Prior M, Arosio E (2013) Young adults with coeliac disease may be at increased risk of early atherosclerosis. Aliment Pharmacol Ther 38:162–169

    Article  PubMed  Google Scholar 

  15. Pham-Short A, Donague KC, Ambler G, Phelan H, Twigg S, Craig ME (2015) Screening for celiac disease in type 1 diabetes: a systematic review. Pediatrics 136:e170–e176

    Article  PubMed  Google Scholar 

  16. Vouristo M, Kesaniemi YA, Gylling H, Miettinen TA (1993) Metabolism of cholesterol and apolipoprotein B in celiac disease. Metabolism 42:1386–1391

    Article  Google Scholar 

  17. Guy J, Ogden L, Wadwa RP et al (2009) Lipid and lipoprotein profiles in youth with and without type 1 diabetes: the SEARCH for Diabetes in Youth case-control study. Diabetes Care 32:416–420

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Cook S, Auinger P, Huang TT (2009) Growth curves for cardio-metabolic risk factors in children and adolescents. J Pediatr 155:S6.e15-26

    PubMed  Google Scholar 

  19. Ciampolini M, Bini S (1991) Serum lipids in celiac children. J Pediatr Gastroenterol Nutr 12:459–460

    Article  CAS  PubMed  Google Scholar 

Download references

Authors’ contributions

Guarantor of the article is Silvana Salardi. Silvana Salardi conceptualized and designed the study and drafted the initial manuscript and took full responsibility for the contents of the article, Giulio Maltoni coordinated and supervised data collection and edited manuscript, Stefano Zucchini contributed to discussion and reviewed the manuscript, Dario Iafusco researched published data and participated in study supervision, Maximiliano Zioutas contributed in statistical analysis, Sonia Toni contributed in interpretation of data and researched data, and A. Z., S. C., M. M., V. C., R. F., I. R., B. P., R. S. and A. S. collected data in each center and reviewed the manuscript. All authors approved the final version for submission.

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Authors and Affiliations

  1. Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 11, 40138, Bologna, Italy

    Silvana Salardi, Giulio Maltoni, Stefano Zucchini & Maximiliano Zioutas

  2. Department of Pediatrics, Second University of Naples, Naples, Italy

    Dario Iafusco, Angela Zanfardino & Santino Confetto

  3. Meyer Pediatric Institute, University of Firenze, Florence, Italy

    Sonia Toni

  4. Department of Life and Reproduction Sciences, Regional Center for Pediatric Diabetes, Clinical Nutrition and Obesity, University of Verona, Verona, Italy

    Marco Marigliano

  5. Pediatric Unit, S. Chiara Hospital, Trento, Italy

    Vittoria Cauvin & Roberto Franceschi

  6. Department of Pediatrics, University of Turin, Turin, Italy

    Ivana Rabbone

  7. Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy

    Barbara Predieri

  8. Endocrinology and Diabetes Palidoro Unit, University Department of Pediatric Medicine, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy

    Riccardo Schiaffini

  9. Pediatric Clinic, Insubria University, Varese, Italy

    Alessandro Salvatoni

Authors
  1. Silvana Salardi
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  2. Giulio Maltoni
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  3. Stefano Zucchini
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  4. Dario Iafusco
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  5. Angela Zanfardino
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  6. Santino Confetto
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  7. Sonia Toni
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  8. Maximiliano Zioutas
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  9. Marco Marigliano
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  10. Vittoria Cauvin
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  11. Roberto Franceschi
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  12. Ivana Rabbone
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  13. Barbara Predieri
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  14. Riccardo Schiaffini
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  15. Alessandro Salvatoni
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Consortia

for the Diabetes Study Group of the Italian Society of Pediatric Endocrinology and Diabetology (ISPED)

Corresponding author

Correspondence to Silvana Salardi.

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Conflict of interest

The authors declare that they have no conflict of interest to disclose.

Human and animal rights disclosure

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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For this type of study formal consent is not required.

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Managed by Massimo Porta.

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Cite this article

Salardi, S., Maltoni, G., Zucchini, S. et al. Whole lipid profile and not only HDL cholesterol is impaired in children with coexisting type 1 diabetes and untreated celiac disease. Acta Diabetol 54, 889–894 (2017). https://doi.org/10.1007/s00592-017-1019-5

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  • DOI: https://doi.org/10.1007/s00592-017-1019-5

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