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. 2022 Jan 18;14(3):414.
doi: 10.3390/nu14030414.

Could I-FABP Be an Early Marker of Celiac Disease in Children with Type 1 Diabetes? Retrospective Study from the Tertiary Reference Centre

Agnieszka Ochocińska  1 , Marta Wysocka-Mincewicz  2 , Artur Groszek  2 , Anna Rybak  3 , Ewa Konopka  4 , Joanna Beata Bierła  4 , Ilona Trojanowska  4 , Mieczysław Szalecki  2   5 , Bożena Cukrowska  4
Affiliations

Could I-FABP Be an Early Marker of Celiac Disease in Children with Type 1 Diabetes? Retrospective Study from the Tertiary Reference Centre

Agnieszka Ochocińska et al. Nutrients. .

Abstract

Patients with type 1 diabetes (T1D) are at higher risk of celiac disease (CD). Recently, intestinal fatty acid binding protein (I-FABP) has been shown to be a serological biomarker of impaired intestinal barrier in CD. Thus, the aim of this study was to verify whether I-FABP could be an early marker of CD in pediatric T1D patients. I-FABP was measured in sera of patients with T1D (n = 156), active CD (n = 38), T1D with active CD (T1D-CD, n= 51), and age-matched healthy children (n = 55). Additionally, I-FABP was determined in T1D patients with negative CD serology at least one year before CD diagnosis (T1D-CD-1, n = 22), in CD patients on a gluten-free diet (CD-GFD, n = 36), and T1D-CD patients on GFD (T1D-CD-GFD, n = 39). Sera were tested using immunoenzymatic assay. Significantly increased levels of I-FABP were found in the T1D, active CD, and T1D-CD groups (1153 ± 665, 1104 ± 916, and 1208 ± 878, respectively) in comparison to healthy with controls (485 ± 416, p < 0.05). GFD induced a significant decrease in I-FABP levels in CD and T1D-CD groups (510 ± 492 and 548 ± 439, respectively). Interestingly, in T1D-CD-1 and T1D, I-FABP levels were comparable (833 ± 369 vs. 1153 ± 665), and significantly increased in relation to healthy controls and T1D-CD values on GFD. The results indicate that the epithelial barrier is disrupted in T1D patients independently of CD development; therefore, I-FABP cannot serve as an early marker of CD in T1D patients. Although GFD can improve epithelial recovery, the question remains as to whether GFD could exert beneficial effects on the intestinal barrier in early stages of T1D.

Keywords: I-FABP; biomarker; celiac disease; gluten-free diet; impaired epithelial barrier; intestinal barrier; intestinal fatty acid binding protein; type 1 diabetes.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Boxplot chart illustrates the distribution of I-FABP concentrations in T1D, CD, T1D-CD, and HC. T1D—type 1 diabetes, CD —celiac disease, T1D-CD—type 1 diabetes and celiac disease, HC- healthy controls; p values were calculated by Kruskal–Wallis test.
Figure 2
Figure 2
Diagnostic value of I-FABP as a marker of CD in T1D patients. AUC—area under curve, CI—confidence interval.
Figure 3
Figure 3
Boxplot chart illustrates the distribution of I-FABP concentrations in T1D-CD, T1D-CD-GFD, and HC patients (A) and CD, CD-GFD, and HC patients (B); p values were calculated by Wilcoxon signed-rank test; * p—T1D-CD (A) or CD (B) vs. HC, ** p—T1D-CD (A) or CD (B) vs. T1D-CD-GFD (A) or CD-GFD (B). T1D-CD—type 1 diabetes and celiac disease, T1D-CD-GFD—type 1 diabetes and celiac disease on gluten free diet, HC—healthy controls, CD—celiac disease, CD—celiac disease on gluten-free diet.
Figure 4
Figure 4
I-FABP concentrations in T1D-CD-1 group in relation to T1D, HC, and T1D-CD-GFD patients; p values were calculated by Wilcoxon signed-rank test; colors of p value fonts correspond to bars of study groups; * p—T1D-CD-1 or T1D vs. HC, ** p—T1D-CD-1 or T1D vs. T1D-CD-GFD. T1D-CD—type 1 diabetes and celiac disease patients with negative CD serology one year before CD diagnosis, T1D—type 1 diabetes, HC —healthy controls, T1D-CD-GFD—type 1 diabetes and celiac disease on gluten-free diet, I-FABP—intestinal fatty acid binding protein.
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