Accuracy of Screening Tests for Celiac Disease in Asymptomatic Patients With Type 1 Diabetes

Am J Gastroenterol. 2021 Jul 1;116(7):1545-1549. doi: 10.14309/ajg.0000000000001193.

Abstract

Introduction: To evaluate the diagnostic performance of celiac serologic tests in asymptomatic patients with type 1 diabetes (T1D).

Methods: Patients with T1D asymptomatic for celiac disease were prospectively screened with immunoglobulin A anti-tissue transglutaminase. Test characteristics were calculated and optimal cutoffs for a positive screen determined.

Results: Two thousand three hundred fifty-three patients were screened and 101 proceeded to biopsy. The positive predictive value of immunoglobulin A anti-tissue transglutaminase at the assay referenced upper limit of normal (30CU) was 85.9%, and the sensitivity and specificity were 100% and 38%, respectively.

Discussion: Thresholds extrapolated from the general population for the diagnostic evaluation of celiac disease are not suitable for use in asymptomatic T1D patients. Population-specific screening cutoffs are required.

Trial registration: ClinicalTrials.gov NCT01566110.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Asymptomatic Diseases*
  • Biopsy
  • Celiac Disease / diagnosis*
  • Celiac Disease / immunology
  • Celiac Disease / pathology
  • Child
  • Diabetes Mellitus, Type 1 / complications*
  • Duodenum / pathology
  • Female
  • GTP-Binding Proteins / immunology
  • Humans
  • Immunoglobulin A / immunology
  • Male
  • Mass Screening
  • Predictive Value of Tests
  • Protein Glutamine gamma Glutamyltransferase 2
  • Sensitivity and Specificity
  • Serologic Tests
  • Transglutaminases / immunology
  • Young Adult

Substances

  • Immunoglobulin A
  • Protein Glutamine gamma Glutamyltransferase 2
  • Transglutaminases
  • GTP-Binding Proteins

Associated data

  • ClinicalTrials.gov/NCT01566110