Helicobacter pylori Infection in Children with Concurrent Celiac Disease and Type 1 Diabetes Mellitus.

ABSTRACT

OBJECTIVES: Data regarding Helicobacter pylori (Hp) infection frequency in concurrent celiac disease (CD) and type 1 diabetes mellitus (T1DM) (CD + T1DM) are anecdotal. This study aimed to evaluate the association between Hp and concomitant CD + T1DM in children. METHODS: In this 2-center, case-control study, children who underwent esophago-gastro-duodenoscopy (EGD) were studied. CD diagnosis was established by favorable histology and serology. Hp infection was confirmed by both histology and the rapid urease test. Patients were divided into 3 groups as CD only (CDo), CD + T1DM, and non-CD children who underwent endoscopy as controls. RESULTS: Among the 1,431 EGDs performed, 783 cases were eligible. Overall, 215 cases had CDo (mean age 9.12 ± 4.18 years, 58.1% girls), 63 cases had CD + T1DM (mean age 9.29 ± 4.46 years, 50.8% girls), and 505 cases were controls (mean age 9.69 ± 4.52 years, 56.6% girls). Hp infection rate was significantly lower in CD + T1DM group (controls 49.7% vs. CDo 32.1% vs. CD + T1DM 20.6%, p < 0.01). After adjustment for age, gender, and socioeconomic status, the Hp infection rate was still significantly low (adjusted odds ratio [aOR] 1.57, 95% confidence interval (CI) 1.35-1.83, p < 0.01). A difference in Hp infection rate between controls and CDo group (aOR 1.43, 95% CI 1.09-2.12, p < 0.05), and between CDo and CD + T1DM (aOR 0.89, 95% CI 0.65-1.54, p < 0.05) group was significant. The severity of duodenal lesions and the presence of Hp infection were not correlated in all celiac children (r 0.113, p > 0.05). CONCLUSION: The frequency of Hp infection was significantly lower in CD + T1DM children, compared to the CDo group and the controls.