Tiempo de exposición al gluten y marcadores de riesgo de diabetes mellitus insulino dependiente en pacientes celíacos

• Sandra Verbeke P ^[1] ; Sylvia Cruchet M ^[1] ; Martín Gotteland R ^[1] ; Gloria Ríos M ^[3] ; Bessie Hunter M ^[2] ; Eduardo Chávez C ^[4] ; Oscar Brunser T ^[1] ; Magdalena Araya Q ^[1]
  1. [1] Universidad de Chile

     Universidad de Chile

     Santiago, Chile

     
  2. [2] Hospital Luis Calvo Mackenna

     Hospital Luis Calvo Mackenna

     Santiago, Chile

     
  3. [3] Hospital Clínico Exequiel González Cortés Gastroenterología Pediátrica
  4. [4] Hospital San Borja Arriarán Unidad de Gastroenterología Pediátrica

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• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 132, Nº. 8, 2004, págs. 979-984
• Idioma: español
• Títulos paralelos:
  • Risk markers for insulin-dependent diabetes mellitus and duration of exposure to gluten in celiac patients
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• Resumen

  • 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)