http://europepmc.org/articles/PMC3221615//reload=0;jsessionid=cMnhJwEYr2MaVmQVRmZS.8

BackgroundHigher serological prevalence rates of helicobacter pylori (H. pylori) infection have been reported in patients with type 1 diabetes (T1DM) and autoimmune thyroiditis (AT). Patients with T1DM are at increased risk for developing other autoimmune diseases, most commonly AT. It is unknown whether H. pylori infection could explain the high prevalence of thyroid autoantibodies and AT in T1DM. The aim of the current study was to evaluate anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) autoantibodies in correlation with anti-H. pylori IgG and IgA in young patients with T1DM.

MethodsAnti-H. Pylori IgG, IgA, anti-TPO and anti-Tg antibodies titers were measured in 162 euthyroid patients with T1DM and 80 healthy controls matched for age, sex and socioeconomic status.

ResultsSeroprevalence of H. pylori was significantly higher in patients with T1DM than in healthy controls; 79% vs. 51.2%, p < 0.001. Anti H. pylori IgG was positive in 61.1% of patients with T1DM and 30% of controls, p < 0.001, anti H. pylori IgA was positive in 74% of patients with T1DM and 32.5% of controls, p < 0.001. Thyroid autoimmunity was also significantly higher in patients with T1DM than in controls; 56.7% vs. 6.2%, p < 0.001. Anti-TPO was positive in 25.3% of patients with T1DM and 3.7% of controls, p < 0.001, anti-Tg was positive in 47.5% of patients with T1DM and 6.2% of controls, p < 0.001. With simple and multiple regression analysis anti-H. pylori IgG and IgA titers were positively and significantly correlated with Anti-TPO and anti-Tg titers in patients with T1DM.

Conclusionour results support the idea of a connection between H. pylori infection and the occurrence of anti-TPO, anti-Tg autoantibodies and AT in young patients with T1DM. So, H. pylori infection could be considered as an environmental trigger for development of AT in T1DM. Young patients with T1DM should be screened for H. pylori infection.

Background

Helicobacter pylori (H. pylori) is one of the most common chronic infections worldwide [1,2]. It affects approximately 50% of the world population and more prevalent in developing than in developed countries [3], however, the majority of infected subjects develop no clinical symptoms [4]. H. pylori specifically colonizes the gastric epithelium and causes chronic gastritis, peptic ulcer disease and/or gastric malignancies [5]; moreover, it has been epidemiologically linked to some extradigestive diseases [6]. Higher serological prevalence rates of H. pylori infection have been previously reported in patients with type 1 diabetes (T1DM) [7] and autoimmune thyroiditis (AT) [8].

Patients with T1DM are at increased risk for developing other autoimmune diseases, most commonly AT [9,10]. Up to 20% of patients with T1DM have positive anti-thyroid antibodies; anti-thyroglobulin (anti-Tg) and anti-thyroid peroxidase (anti-TPO) antibodies and 2 to 5% of patients with T1DM develop autoimmune hypothyroidism [11].

Thus, the question arises is whether H. pylori infection could be a reason for the increased prevalence of thyroid autoantibodies and AT in T1DM; so it might be considered as an environmental trigger for development of AT. The aim of the present study was to evaluate anti-TPO and anti-Tg autoantibodies in correlation with anti-H. pylori IgG and IgA in young patients with T1DM.

Methods

Selection of patients with T1DM and healthy controlsOne hundred and sixty two euthyroid patients with T1DM (90 female and 72 male; mean age: 19.35 2.6 years; diabetes duration: 7.29 7.9) attending out-patient diabetes clinics at Pediatric and Specialized Medical Hospitals, Mansoura University, Egypt were studied (Table (Table1).1). The diagnosis and clinical classification of diabetes mellitus were based on the guidelines of the American Diabetes Association [12]. Eighty healthy participants matched for age, sex and socioeconomic status, coming from the same geographic area, were evaluated as controls. A validated questionnaire concerning the presence of dyspeptic symptoms (epigastric pain, bloating, post prandial fullness, nausea and vomiting) was administered. All participants signed an informed consent to be included in our study. This study was approved by the local ethical committee.
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