{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T01:33:20Z","timestamp":1760578400264,"version":"build-2065373602"},"reference-count":28,"publisher":"The Endocrine Society","issue":"11","license":[{"start":{"date-parts":[[2025,3,8]],"date-time":"2025-03-08T00:00:00Z","timestamp":1741392000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Children and adolescents with type 1 diabetes (T1D) have a higher risk of developing celiac disease (CD) than the general population. However, the main screening antibody, IgA anti-transglutaminase 2 (TGA-IgA), can fluctuate in T1D and there is no threshold for performing diagnostic biopsies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The study aims to define an optimal TGA-IgA cutoff for performing diagnostic biopsies for CD confirmation and to assess whether tracking TGA-IgA evolution or adding other antibodies can improve biopsy indications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Retrospective longitudinal analysis of pediatric T1D individuals diagnosed at 2 centers in Switzerland between 2000 and 2021, from T1D diagnosis to CD diagnosis or the age of 18 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 588 individuals with T1D, comprising 2944 TGA-IgA values. Thirty-four (5.8%) developed CD during follow-up, of whom 50% had CD-associated symptoms at CD diagnosis. Balancing sensitivity and specificity TGA-IgA around 6.1 \u00d7 upper limit of normal was the best cutoff for performing diagnostic biopsies. The inclusion of IgG antibodies against deamidated gliadin peptides achieved a higher area under the curve of 0.79 (95% CI, 0.6-1) with 80% accuracy compared to each antibody alone. CD diagnosis within 2 years of T1D, representing two thirds of CD, was marked by elevated TGA-IgA at T1D diagnosis. Later CD diagnosis was associated with a more gradual increase of TGA-IgA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our results suggest an indication for biopsy for CD confirmation at a TGA-IgA cutoff around 6.1 \u00d7 upper limit of normal. Including IgG antibodies against deamidated gliadin peptides can potentially increase precision. TGA-IgA determination at T1D diagnosis may help to identify individuals at risk of CD early on.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf146","type":"journal-article","created":{"date-parts":[[2025,3,8]],"date-time":"2025-03-08T14:07:31Z","timestamp":1741442851000},"page":"e3685-e3693","source":"Crossref","is-referenced-by-count":2,"title":["Antibodies Are Predictive for Diagnosis of Celiac Disease in Pediatric Type 1 Diabetes"],"prefix":"10.1210","volume":"110","author":[{"given":"Nadja Zoe","family":"M\u00fcller","sequence":"first","affiliation":[{"name":"Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern , 3012 Bern ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iulia-Maia","family":"Muresan","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, University of Bern , 3012 Bern 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