Variations of interleukin (IL) 1 Beta (IL 1 β) and interferon gamma (INF-Ɣ) in Diabetic and Non-Diabetic Celiac Patients

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Albayati, Iftikhar Khawwam Kadhim, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6617269/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Celiac disease (CD) is a chronic autoimmune disorder characterized by a noxious immune response to gluten in genetically susceptible persons. CD has a coincidence with diabetes mellitus, particularly type 1 diabetes, due to shared genetic risk factors and autoimmune mechanisms. Aim This study aims to test the levels of IFN-γ and IL-1β in diabetic and non-diabetic Celiac patients, and to explore the relationship between these cytokines and disease activity. Methods Eighty children with CD (diabetic and non-diabetic) were enrolled in this study. Serum levels of anti- tissue transglutaminase IgG (IgG-tTG) and IgA (IgA-tGA), IFN-γ and IL-1β were measured using ELISA, and statistical analysis was performed to compare the levels of these cytokines between the two groups. Results The results revealed significantly higher levels of IFN-γ and IL-1β in diabetic celiac patients compared to non-diabetic ones. Females showed higher levels of these cytokines compared to males. Of note, a positive correlation was found between IL-1β and IFN-γ in diabetic celiac patients. Conclusion The study highlights the importance of inflammatory cytokines like IFN-γ and IL-1β in the pathogenesis and development of symptoms in CD, particularly in the context of comorbidities like diabetes mellitus. Understanding the inflammatory profile of CD in different metabolic contexts may support the management. Immunology Autoimmune diseases celiac disease comorbidity diabetes mellitus inflammatory cytokines IFN-γ IL-1β Figures Figure 1 Figure 2 Figure 3 Introduction Coeliac disease (CD) is a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed individuals (Ludvigsson JF et al 2013 ). This immune response leads to inflammation and damage in the small intestine, resulting in malabsorption of essential nutrients (Hill ID et al 2016 ). The first consensus definition of CD was published in Acta Paediatrica in 1970. This publication defined CD as a permanent condition of gluten intolerance with mucosal flattening that (a) reversed on a gluten-free diet (GFD) and (b) then relapsed on re-introduction of gluten. Although the definition of CD has undergone minor changes since 1970, consensus definitions have been restricted to CD. However, the scientific community has come to recognize that there is a spectrum of disorders related to gluten ingestion (Ludvigsson JF et al 2013 ). There has been a substantial increase in the prevalence of CD over the last 50 years and many patients remain undiagnosed. Diagnostic testing, including serology and biopsy, should be performed on a gluten-containing diet. The diagnosis of CD is based on a combination of clinical, serological and histopathological data. The treatment for CD is primarily a gluten-free diet (GFD), which requires significant patient education, motivation and follow-up. (Al-Toma A et al 2019 ) Interplay between Diabetes type 1 (T1D) and CD: Although numerous studies have suggested a potentially pathogenic role of gluten in T1D, the exact mechanisms by which it may play a role in the onset and development of T1D are not yet fully understood. Studies in human samples have reported that upon stimulation with wheat proteins or their components, patients with T1D showed a heightened proliferative T cell response as compared to control patients. PBMC from these patients produced significantly more pro-inflammatory cytokines compared to control subjects. Similarly, Klemetti et al. found that PBMC from T1D patients proliferated more as compared to controls when stimulated with wheat proteins. (Serena, G et al 2015 ) Due to the insidious autoimmune background, patients with T1DM are at an increased risk of developing other autoimmune disorders (ADs), and one of the most relevant is CD. CD has a worldwide frequency of 1%, and it rises at approximately 5% in T1DM patients, which makes it one of the most frequent ADs occurring in T1DM (Flores Monar GV et al 2022 ) Nilsen EM et al studied the antigen induced production of cytokines from gluten specific T cell clones (TCC) in coeliac intestinal lesions, in addition to exploring their HLA-restriction patterns. All TCC were found to secrete interferon (IFN) gamma; some secreted in addition interleukin (IL) 4, IL 5, IL 6, IL 10, tumour necrosis factor (TNF), and transforming growth factor (TGF) beta. They concluded that most DQ8 restricted TCC seemed to fit with a Th0 profile whereas the DQ2 restricted TCC secreted cytokines more compatible with a Th1 pattern (Nilsen EM et al 1995 ). In active CD, activated T cells in the small intestinal mucosa produce the Th1 cytokine interferon (IFN)– gamma. A role for cytokines in mediating mucosal damage has also been proposed for interleukin (IL)–1 and tumor necrosis factor (TNF)–, as these cytokines have been shown to increase the expression of certain metalloproteinases (MMP-1 and MMP-3) with consequent degradation of extracellular matrix (ECM) components (Manavalan JS et al 2010 ) Aim: The complicated interplay between CD and diabetes makes it essential to investigate the inflammatory profile of CD in both diabetic and non-diabetic patients. Hence, this study aims to test the levels of IFN-γ and IL-1β in diabetic and non-diabetic Celiac patients, and to explore the relationship between these cytokines and disease activity. Materials and Methods Among the 365 children examined in the Specialized Center for Endocrinology and Diabetes Baghdad / Rusafa for anti- tissue transglutaminase IgG (IgG-tTG) and IgA (IgA-tGA) antibodies using ELISA method, only 80 children (males and females) show positive results for these antibodies and labelled as celiac patients. Inclusion and exclusion criteria: children with celiac, diabetics and non-diabetics, with no obvious other diseases and no current medications Their age range was 3–15 years. The study was conducted during the period extended from July 2024 to September 2024. Recorded investigations confirmed that some of them have diabetes mellitus (DM) while others have no. Further investigations were done to measure the serum levels of specific cytokines, namely INF-γ and IL-1β to explore the inflammatory status of these patients. The ELISA was also used for this measurement. Results were tabulated and interpreted. Statistical analysis: The ANOVA test was used to analyze repeated measures between tested groups. Data expressed as mean ± SD and other descriptive statistics. For the descriptive analysis subjected to Chi-square test, values of p > 0.05 were considered statically non-significant while p ≤ 0.05 were considered significantly different. Estimate of correlation coefficient between difference parameters in this study was done. The statistical analysis was carried out by SPSS (v 20). Results Table 1 shows the distribution of the celiac patients according to gender and presence/absence of diabetes with no significant difference concerning these factors Table 1 Gender distribution of Diabetic and Non-Diabetic celiac patients enrolled in the study Gender distributions Diabetic patient (DP) N(%) Non-Diabetic patient (NDP) N(%) Male 17(42.5) 20(50) Female 23(57.5) 20(50) The chi-square statistic is 0.4525. The p -value is 0.501129. The result is not significant at p < .05. Table 1 : Gender distribution of Diabetic and Non-Diabetic celiac patients enrolled in the study Table 2 shows the statistical analysis of age in different groups of male and female celiac patients (Diabetic and non-Diabetic). No significant difference was recorded among the study group Table 2 Age distribution of Diabetic and Non-Diabetic celiac patients (male and female) enrolled in the study Age /year Female Male DP NDP DP NDP N 23 20 17 20 Mean 11.61 10.45 10.88 11.15 Std. Error of Mean 0.76 0.65 0.71 0.71 Median 13.00 10.50 12.00 12.50 Std. Deviation 3.63 2.93 2.91 3.17 Minimum 3.00 4.00 5.00 5.00 Maximum 15.00 15.00 15.00 14.00 P value 0.73 non-sig 0.81 non-sig P value Male vis female diabetic patients: 0.71 non sig P value Male vis female non diabetic patients 0.58 non sig P ≤ 0.05 is considered statically significant Table 2 : Age distribution of Diabetic and Non-Diabetic celiac patients (male and female) enrolled in the study Table 3 shows level of Anti- tissue transglutaminase IgG (IgG-tTG). Significant difference was noticed between the two groups among female celiac patients; being diabetic female patients demonstrated higher levels of Anti-t-IgG, as well as among male patients. Of note, diabetic female exhibited significantly higher levels as compared to male ones; with a similar significance was seen among non-diabetic females and males Table 3 Levels of Anti- tissue transglutaminase IgG (IgG-tTG) among different groups enrolled in the study Anti- tTG IgG Female Male DP NDP DP NDP N 23 20 17 20 Mean 195.08 145.14 111.87 97.76 Std. Error of Mean 26.37 29.37 20.74 29.33 Median 230.35 56.80 83.85 27.90 Std. Deviation 37.91 55.86 32.77 27.94 Minimum 42.30 35.40 12.00 22.50 Maximum 341.00 232.00 312.00 255.00 P value 0.001 SIG 0.05 SIG P value Male vis female diabetic patients 0.001 SIG P value Male vis female non diabetic patients 0.001 SIG P ≤ 0.05 is considered statically significant Table 3 : Levels of Anti- tissue transglutaminase IgG (IgG-tTG) among different groups enrolled in the study Level of Anti- tissue transglutaminase IgA (IgA-tTG) antibodies are demonstrated in Table 4 . Significant difference was noticed between the two groups among female celiac patients; being diabetic female patients revealed higher levels of IgA-tTG antibodies, but it was not the same case among male patients. While diabetic females exhibited significantly higher levels as compared to male ones, the difference among non-diabetic females and males was not significant Table 4 Levels of Anti- tissue transglutaminase IgA (IgA-tTG) among different groups enrolled in the study Anti -tTG IgA Female Male DP NDP DP NDP N 23 20 17 20 Mean 160.11 139.95 113.11 125.27 Std. Error of Mean 33.99 30.60 33.26 30.09 Median 155.80 44.30 26.10 57.50 Std. Deviation 52.02 46.77 37.13 34.58 Minimum 31.80 23.80 19.10 33.90 Maximum 367.00 331.00 285.00 315.00 P value 0.01 SIG 0.09 non sig P value Male vis female diabetic patients 0.003 SIG P value Male vis female non diabetic patients 0.08 non sig P ≤ 0.05 is considered statically significant Table 4 : Levels of Anti- tissue transglutaminase IgA (IgA-tTG) among different groups enrolled in the study In Table 5 , it is clear that levels of Interferon gamma (IFN-γ) varied significantly between diabetic and non-diabetic groups in female celiac patients; being diabetic female patients revealed higher levels of IFN-γ, and a similar condition was recorded among male patients. Notably, diabetic females showed significantly higher levels as compared to males, but the difference among non-diabetic females and males was not significant Table 5 Levels of Interferon gamma (IFN-γ) among different groups enrolled in the study IFN-γ Female Male DP NDP DP NDP N 23 20 17 20 Mean 76.25 41.10 62.92 47.22 Std. Error of Mean 25.08 4.01 13.37 6.37 Median 48.58 34.19 50.10 40.43 Std. Deviation 20.26 17.94 15.14 28.50 Minimum 35.93 27.834 5.06 26.21 Maximum 605.59 92.251 85.37 44.73 P value 0.002 SIG 0.05 SIG P value Male vis female diabetic patients 0.05 SIG P value Male vis female non diabetic patients 0.33 non SIG P ≤ 0.05 is considered statically significant Table 5 : Levels of Interferon gamma (IFN-γ) among different groups enrolled in the study In Table 6 , there is a highly significant difference in levels of interleukin-1 Bata (IL1β) in both of the females celiac patients groups (diabetics and non-diabetics), with similarity to recorded levels among male patients. Additionally, diabetic females showed significantly higher levels with comparison to males, unlike the difference among non-diabetic females and males Table 6 Levels of interleukin-1 Bata (IL1β) among different groups enrolled in the study IL1β Female Male DP NDP DP NDP N 20 23 20 17 Mean 452.743 136.91 382.347 134.245 Std. Error of Mean 41.3 26.36 57.9 22.8 Median 625.402 114.57 389.061 144.66 Std. Deviation 84.73 26.41 25.93 54.28 Minimum 373.58 189.777 326.28 185.61 Maximum 825.42 471.586 986.93 366.99 P value 0.0001 SIG 0.0001 SIG P value Male vis female diabetic patients 0.001 SIG P value Male vis female non diabetic patients 0.78 non sig P ≤ 0.05 is considered statically significant Table 6 : Levels of interleukin-1 Bata (IL1β) among different groups enrolled in the study Statistical correlation among investigated parameters was studied (Table 7 , Fig. 1 and Fig. 2 ). We considered the total number of Diabetic celiac patients and the correlation among their parameters was explored. Results revealed highly significant positive statistical correlation between IgA-tTG and IgG-tTG Antibodies. Also, IL1β and IFN-γ are correlated with a high statistical significance Table 7 Correlation among parameters of the Diabetic celiac patients enrolled in the study Correlations Diabetic patient Age IgG-tTG IgA-tTG INF- γ IL1β Age Pearson Correlation 1 − .046 .062 .037 − .014 Sig. (2-tailed) .780 .702 .823 .931 N 40 40 40 40 40 IgG-tTG Pearson Correlation − .046 1 .686 ** .251 .212 Sig. (2-tailed) .780 .000 .118 .190 N 40 40 40 40 40 IgA-tTG Pearson Correlation .062 .686 ** 1 − .066 − .026 Sig. (2-tailed) .702 .000 .684 .874 N 40 40 40 40 40 INF- γ Pearson Correlation .037 .251 − .066 1 .839 ** Sig. (2-tailed) .823 .118 .684 .000 N 40 40 40 40 40 IL1β Pearson Correlation − .014 .212 − .026 .839 ** 1 Sig. (2-tailed) .931 .190 .874 .000 N 40 40 40 40 40 **. Correlation is significant at the 0.01 level (2-tailed). Table 7 : Correlation among parameters of the Diabetic celiac patients enrolled in the study Table 8 (and Fig. 3 ) demonstrate correlation among investigated parameters in the total number of Non- Diabetic celiac patients. Unlike the previous one, a negative statistical correlation between IgA-tTG antibodies and IL1β was recorded Table 8 Correlation among parameters of the Non-Diabetic celiac patients enrolled in the study Correlations Non Diabetic patient Age A-T IgG A-T IgA INF- γ IL1β Age Pearson Correlation 1 − .064 .198 − .225 − .081 Sig. (2-tailed) .699 .226 .169 .626 N 40 40 40 40 40 IgG-tTG Pearson Correlation − .064 1 .057 .065 .029 Sig. (2-tailed) .699 .726 .690 .859 N 40 40 40 40 40 IgA-tTG Pearson Correlation .198 .057 1 .018 − .349 * Sig. (2-tailed) .226 .726 .913 .027 N 40 40 40 40 40 INF- γ Pearson Correlation − .225 .065 .018 1 .025 Sig. (2-tailed) .169 .690 .913 .879 N 40 40 40 40 40 IL1β Pearson Correlation − .081 .029 − .349 * .025 1 Sig. (2-tailed) .626 .859 .027 .879 N 40 40 40 40 40 *. Correlation is significant at the 0.05 level (2-tailed). Table 8 : Correlation among parameters of the Non-Diabetic celiac patients enrolled in the study Discussion Celiac disease (CD) is a chronic inflammatory intestinal disorder. Different immunological factors, including inflammatory cytokines, may play an important role in disease susceptibility. (Barartabar Z et al 2018 ( The prevalence of celiac disease has increased in the last decades, suggesting a role for environmental factors in addition to gluten. (Caminero A et al 2019) The manifestations may vary from overt enteropathy to extraintestinal forms, and the symptoms may even be silent (Dahlbom I et al 2005 ) In this study, the levels of Anti- tissue transglutaminase IgG (IgG-tTG) were higher in diabetic female celiac patients as compared to non-diabetic ones. Male patients also demonstrated significant difference in the same picture. When we contrast diabetic female with diabetic males, IgG-tTG shows significantly higher levels in the former, with similar difference among female and male non-diabetic celiac patients. In the case of Anti- tissue transglutaminase IgA (IgA-tTG) diabetic female celiac patients exhibited significantly higher levels of these antibodies when compared to non-diabetic patients. Unlikely, there was no significant difference among male (diabetic and non-diabetic) celiac patients. However, diabetic females significantly differ from diabetic males regarding those levels, but the difference among non-diabetic females and males was not significant These results can be set as an agreement with some records like Kaur N et al. They found that assay format detecting IgA + IgG helped in the detection of potential CD in asymptomatic T1D patients (Kaur N et al 2019 ) Besides, Lewandowska K reported that tests based on anti-TG IgA are more accurate for detecting CD in children with type 1 diabetes than anti- deamidated gliadin peptide (anti-DGP) IgA (Lewandowska K et al) The higher levels of Anti- tissue transglutaminase in diabetic celiac patients may be attributed to the high rate of comorbidities between celiac and diabetes (especially type 1DM). The association between CD and T1D was first reported in the late 1960s. The prevalence of CD in patients with T1D is estimated to fall between 1.4% and 19.7%. This comorbidity can largely be attributed to overlapping genetic HLA risk loci; in both conditions, the HLA-DQ2 and DQ8 genes have been shown to be important determinants of disease susceptibility (Serena, G et al 2015 ). As Interferon gamma (IFN-γ) levels, an important inflammatory indicator, are explored in this study, we noticed significant difference between diabetic and non-diabetic groups in female celiac patients; with clear higher levels of IFN-γ among diabetic female patients, and a similar significance was revealed among male patients. A comparison between diabetic females and males declared significantly higher levels in the former. With no significant difference among non-diabetic females and males resulted. Another important inflammatory indicator, interleukin-1 Bata (IL1β), was investigated among the study groups. We can say that the statistical significance here is almost similar to that seen in IFN-γ case There is evidence that cytokines, in particular interleukin-1 beta (IL1β) and interferon-gamma (IFN-gamma) might mediate beta cell destruction in type 1 diabetes. (Ciampolillo A et al 1993 ) It is well known that there is a harmony effect of inflammatory process in various autoimmune diseases. CD arises in genetically susceptible individuals with HLA-DQ2 or HLA-DQ8 alleles and is characterized by a T-cell-driven inflammation in the proximal small bowel triggered by gluten ingestion. Gluten is delivered to TCD4 + cell and activates them causing the secretion of different pro-inflammatory and inflammatory cytokines such as interferon (IFN)-γ, interleukin IL-1, IL-6, IL-8, and others. After this event, TCD4 + cell interaction with B cells leads to the release of autoantibodies such as anti-tissue transglutaminase (tTG) and DGA (Deamidated gliadin antibody) which is a marker for active disease. The IL-1 family consists of 11 cytokines and has been also expanded to 9 distinct genes that have emerged as a therapeutic mark for auto-inflammatory diseases such as CD. IL-1α and IL-1β have highly inflammatory effects, and have been evaluated in various studies. Some studies recorded elevated serum IL-1 and IL-1β which was associated with increased CD and its symptoms (Nasserinejad M et al 2019 ), making it consistent with our results. Hence, the role of IFN-γ and IL1β in diabetic celiac patients becomes clear if this study’s results are considered. To test the correlation among the studied parameters in diabetic celiac patients, a highly significant positive statistical correlation between IgA-tTG and IgG-tTG Antibodies was found, as well as that between IL1β and IFN-γ This means that as one of the correlated parameters increases, the corresponding one increases and vice versa. Given those finding, more confirmation is achieved regarding the profound inflammatory process encountered in such autoimmune diseases. On the contrary, in non- diabetic celiac patients a negative statistical correlation between IgA-tTG and IL1β resulted. This refers to an inverse relation between them in such patients. In general, the widely accepted concept of higher incidence of autoimmune diseases in females as compared to males can explain the significantly higher results in females in this study Conclusion Inflammatory cytokines like IFN-γ and IL1β are important factors in both pathogenesis and development of symptoms in celiac diseases, and this may vary clearly when comorbidities are accompanying celiac; as diabetes mellitus. A comprehensive interpretation of the inflammatory profile of CD in different metabolic contexts may support the development of novel therapeutic strategies for the management of CD and related disorders. Declarations Acknowledgements: We would like to thank Mrs. Dalya Falah Hassan (MSc Microbiology) and the staff of the Specialized Centre of Endocrinology and Diabetes - Rusafa / Baghdad - Iraq; the manager and Dr. Asma Ghalib Abid (M.B.Ch.B, M.Sc, F.I.C.M.S / path.immune) for their valuable contributions and support Funding The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. Competing Interests The authors have no relevant financial or non-financial interests to disclose. The authors have no competing interests to declare that are relevant to the content of this article. Author Contributions All authors contributed to the study conception and design. Material preparation, data collection and analysis, examining the patients and selecting those who meet the inclusion criteria and laboratory work were performed by: Hind Suhail Ali, Asaad F. Albayati, Nameer Mahdi Salih, Iftikhar Khawwam and Abdulrahman Shakir Abd. The first draft of the manuscript was written by Asaad F. Albayati and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript . Data Availability The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request. Ethics approval This study was conducted under the approval granted by the Ethical approval Committee of College of Medicine/ Al-Iraqia University Consent to participate Written informed consent was obtained from the parents. References Al-Toma A, Volta U, Auricchio R, Castillejo G, Sanders DS, Cellier C, Mulder CJ, Lundin KEA (2019) European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterol J 7:583-613. https://doi.org/10.1177/2050640619844125 Barartabar Z, Nikzamir A, Sirati-Sabet M, Aghamohammadi E, Chaleshi V, Rostami Nejad M, Asadzadeh-Aghdaei H, Reza Zali M (2018) The relationship between 174 G/C and -572 G/C of IL-6 gene polymorphisms and susceptibility of celiac disease in the Iranian population. Prz Gastroenterol 13:293-298. https://doi.org/10.5114/pg.2018.79808 Caminero A, Verdu EF (2019) Celiac disease: should we care about microbes? Am J Physiol Gastrointest Liver Physiol 317:G161-G170. https://doi.org/10.1152/ajpgi.00099.2019 Ciampolillo A, Guastamacchia E, Caragiulo L, Lollino G, De Robertis O, Lattanzi V, Giorgino R (1993) In vitro secretion of interleukin-1 beta and interferon-gamma by peripheral blood lymphomononuclear cells in diabetic patients. Diabetes Res Clin Pract 21:87-93. https://doi.org/10.1016/0168-8227(93)90054-9 Dahlbom I, Olsson M, Forooz NK, Sjöholm AG, Truedsson L, Hansson T (2005) Immunoglobulin G (IgG) anti-tissue transglutaminase antibodies used as markers for IgA-deficient celiac disease patients. Clin Diagn Lab Immunol 12:254-258. https://doi.org/10.1128/CDLI.12.2.254-258.2005 Flores Monar GV, Islam H, Puttagunta SM, Islam R, Kundu S, Jha SB, Rivera AP, Sange I (2022) Association Between Type 1 Diabetes Mellitus and Celiac Disease: Autoimmune Disorders With a Shared Genetic Background. Cureus 14:e22912. https://doi.org/10.7759/cureus.22912 Hill ID, Fasano A, Guandalini S, Hoffenberg E, Levy J, Reilly N, Verma R (2016) NASPGHAN Clinical Report on the Diagnosis and Treatment of Gluten-related Disorders. J Pediatr Gastroenterol Nutr 63:156-165. https://doi.org/10.1097/MPG.0000000000001216 Kaur N, Minz RW, Bhadada SK, et al (2019) Role of anti-tissue transglutaminase IgA+IgG antibodies in detection of potential celiac disease in patients with type 1 diabetes. Indian J Med Res 149:18-25. https://doi.org/10.4103/ijmr.IJMR_1136_16 Lewandowska K, Ciepiela O, Szypowska A, Wyhowski J, Głodkowska-Mrówka E, Popko K, Ostafin M, Pyrżak B, Demkow U (2018) Celiac antibodies in children with type 1 diabetes - A diagnostic validation study. Autoimmunity 51:81-88. https://doi.org/10.1080/08916934.2018.1427226 Ludvigsson JF, Leffler DA, Bai JC, et al (2013) The Oslo definitions for coeliac disease and related terms. Gut 62:43-52. https://doi.org/10.1136/gutjnl-2011-301346 Manavalan JS, Hernandez L, Shah JG, Konikkara J, Naiyer AJ, Lee AR, Ciaccio E, Minaya MT, Green PH, Bhagat G (2010) Serum cytokine elevations in celiac disease: association with disease presentation. Hum Immunol 71:50-57. https://doi.org/10.1016/j.humimm.2009.09.351 Nasserinejad M, Shojaee S, Ghobakhlou M, Lak E, Eslami P, Pourhoseingholi MA (2019) The effects of IL-8, IL-6, and IL-1 on the risk of celiac disease: a Bayesian regression analysis. Gastroenterol Hepatol Bed Bench 12:S117-S122. PMID: 32099611; PMCID: PMC7011063 Nilsen EM, Lundin KE, Krajci P, Scott H, Sollid LM, Brandtzaeg P (1995) Gluten specific, HLA-DQ restricted T cells from coeliac mucosa produce cytokines with Th1 or Th0 profile dominated by interferon gamma. Gut 37:766-776. https://doi.org/10.1136/gut.37.6.766 Serena G, Camhi S, Sturgeon C, Yan S, Fasano A (2015) The Role of Gluten in Celiac Disease and Type 1 Diabetes. Nutrients 7:7143-7162. https://doi.org/10.3390/nu7095329 Additional Declarations The authors declare no competing interests. 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Albayati","email":"data:image/png;base64,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","orcid":"https://orcid.org/0000-0001-7116-1483","institution":"Al-Iraqia University / College of Medicine","correspondingAuthor":true,"prefix":"","firstName":"Asaad","middleName":"F.","lastName":"Albayati","suffix":""},{"id":457073137,"identity":"105a633d-2959-43a3-8b23-f5eb7d7ea81f","order_by":3,"name":"Iftikhar Khawwam Kadhim","email":"","orcid":"","institution":"Specialized centre of Endocrinology and Diabetes -Rusafa- Baghdad - Iraq","correspondingAuthor":false,"prefix":"","firstName":"Iftikhar","middleName":"Khawwam","lastName":"Kadhim","suffix":""},{"id":457073138,"identity":"c44012d4-e6f1-49a4-9a8e-3c1ae06615fd","order_by":4,"name":"Abdulrahman Shakir Abd","email":"","orcid":"","institution":"Al-Iraqia University / College of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Abdulrahman","middleName":"Shakir","lastName":"Abd","suffix":""}],"badges":[],"createdAt":"2025-05-08 06:26:58","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-6617269/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6617269/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":82892584,"identity":"fda81953-a0c0-4072-8f88-a4c8f72c738a","added_by":"auto","created_at":"2025-05-16 12:20:04","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":208286,"visible":true,"origin":"","legend":"\u003cp\u003eGraphic representation of correlation between IgA-tTG and IgG-tTG Antibodies levels in the Diabetic celiac patients enrolled in the study\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-6617269/v1/1f8187f448afe4a90d5dd39c.png"},{"id":82893743,"identity":"59a7a813-dc12-4b3c-8145-9de957df9a71","added_by":"auto","created_at":"2025-05-16 12:28:04","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":217118,"visible":true,"origin":"","legend":"\u003cp\u003eGraphic representation of correlation between IL1β and IFN-γ levels in the Diabetic celiac patients enrolled in the study\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-6617269/v1/637f6bb74c85bff98ccbee77.png"},{"id":82892590,"identity":"e7cf2167-a83d-4914-87fa-b7402b68e584","added_by":"auto","created_at":"2025-05-16 12:20:04","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":218417,"visible":true,"origin":"","legend":"\u003cp\u003eGraphic representation of correlation IgA-tTG antibodies and IL1β levels in the Non-Diabetic celiac patients enrolled in the study\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-6617269/v1/7b7f36b3b6221da481f90ac7.png"},{"id":82895821,"identity":"26a6db37-cc85-4386-83d9-4d89f706f380","added_by":"auto","created_at":"2025-05-16 12:52:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1738972,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6617269/v1/629288ea-0d7a-4418-aaa6-7b070a488e15.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eVariations of interleukin (IL) 1 Beta (IL 1 β) and interferon gamma (INF-Ɣ) in Diabetic and Non-Diabetic Celiac Patients\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eCoeliac disease (CD) is a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed individuals (Ludvigsson JF et al \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). This immune response leads to inflammation and damage in the small intestine, resulting in malabsorption of essential nutrients (Hill ID et al \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe first consensus definition of CD was published in \u003cem\u003eActa Paediatrica\u003c/em\u003e in 1970. This publication defined CD as a permanent condition of gluten intolerance with mucosal flattening that (a) reversed on a gluten-free diet (GFD) and (b) then relapsed on re-introduction of gluten. Although the definition of CD has undergone minor changes since 1970, consensus definitions have been restricted to CD. However, the scientific community has come to recognize that there is a spectrum of disorders related to gluten ingestion (Ludvigsson JF et al \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThere has been a substantial increase in the prevalence of CD over the last 50 years and many patients remain undiagnosed. Diagnostic testing, including serology and biopsy, should be performed on a gluten-containing diet. The diagnosis of CD is based on a combination of clinical, serological and histopathological data. The treatment for CD is primarily a gluten-free diet (GFD), which requires significant patient education, motivation and follow-up. (Al-Toma A et al \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2019\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eInterplay between Diabetes type 1 (T1D) and CD:\u003c/p\u003e \u003cp\u003eAlthough numerous studies have suggested a potentially pathogenic role of gluten in T1D, the exact mechanisms by which it may play a role in the onset and development of T1D are not yet fully understood. Studies in human samples have reported that upon stimulation with wheat proteins or their components, patients with T1D showed a heightened proliferative T cell response as compared to control patients. PBMC from these patients produced significantly more pro-inflammatory cytokines compared to control subjects. Similarly, Klemetti et al. found that PBMC from T1D patients proliferated more as compared to controls when stimulated with wheat proteins. (Serena, G et al \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2015\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eDue to the insidious autoimmune background, patients with T1DM are at an increased risk of developing other autoimmune disorders (ADs), and one of the most relevant is CD. CD has a worldwide frequency of 1%, and it rises at approximately 5% in T1DM patients, which makes it one of the most frequent ADs occurring in T1DM (Flores Monar GV et al \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2022\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eNilsen EM et al studied the antigen induced production of cytokines from gluten specific T cell clones (TCC) in coeliac intestinal lesions, in addition to exploring their HLA-restriction patterns. All TCC were found to secrete interferon (IFN) gamma; some secreted in addition interleukin (IL) 4, IL 5, IL 6, IL 10, tumour necrosis factor (TNF), and transforming growth factor (TGF) beta. They concluded that most DQ8 restricted TCC seemed to fit with a Th0 profile whereas the DQ2 restricted TCC secreted cytokines more compatible with a Th1 pattern (Nilsen EM et al \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e1995\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn active CD, activated T cells in the small intestinal mucosa produce the Th1 cytokine interferon (IFN)\u0026ndash; gamma. A role for cytokines in mediating mucosal damage has also been proposed for interleukin (IL)\u0026ndash;1 and tumor necrosis factor (TNF)\u0026ndash;, as these cytokines have been shown to increase the expression of certain metalloproteinases (MMP-1 and MMP-3) with consequent degradation of extracellular matrix (ECM) components (Manavalan JS et al \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2010\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eAim: The complicated interplay between CD and diabetes makes it essential to investigate the inflammatory profile of CD in both diabetic and non-diabetic patients. Hence, this study aims to test the levels of IFN-γ and IL-1β in diabetic and non-diabetic Celiac patients, and to explore the relationship between these cytokines and disease activity.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eAmong the 365 children examined in the Specialized Center for Endocrinology and Diabetes Baghdad / Rusafa for anti- tissue transglutaminase IgG (IgG-tTG) and IgA (IgA-tGA) antibodies using ELISA method, only 80 children (males and females) show positive results for these antibodies and labelled as celiac patients.\u003c/p\u003e \u003cp\u003eInclusion and exclusion criteria: children with celiac, diabetics and non-diabetics, with no obvious other diseases and no current medications\u003c/p\u003e \u003cp\u003eTheir age range was 3\u0026ndash;15 years.\u003c/p\u003e \u003cp\u003eThe study was conducted during the period extended from July 2024 to September 2024.\u003c/p\u003e \u003cp\u003eRecorded investigations confirmed that some of them have diabetes mellitus (DM) while others have no. Further investigations were done to measure the serum levels of specific cytokines, namely INF-γ and IL-1β to explore the inflammatory status of these patients. The ELISA was also used for this measurement. Results were tabulated and interpreted.\u003c/p\u003e \u003cp\u003eStatistical analysis: The ANOVA test was used to analyze repeated measures between tested groups. Data expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD and other descriptive statistics. For the descriptive analysis subjected to Chi-square test, values of p\u0026thinsp;\u0026gt;\u0026thinsp;0.05 were considered statically non-significant while p\u0026thinsp;\u0026le;\u0026thinsp;0.05 were considered significantly different. Estimate of correlation coefficient between difference parameters in this study was done. The statistical analysis was carried out by SPSS (v 20).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the distribution of the celiac patients according to gender and presence/absence of diabetes with no significant difference concerning these factors\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eGender distribution of Diabetic and Non-Diabetic celiac patients enrolled in the study\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender distributions\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiabetic patient (DP)\u003c/p\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNon-Diabetic patient (NDP) N(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17(42.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20(50)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23(57.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20(50)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eThe chi-square statistic is 0.4525. The\u0026nbsp;\u003cem\u003ep\u003c/em\u003e-value is 0.501129. The result is\u0026nbsp;\u003cem\u003enot\u003c/em\u003e\u0026nbsp;significant at\u0026nbsp;\u003cem\u003ep\u003c/em\u003e\u0026nbsp;\u0026lt; .05.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e: \u003cb\u003eGender distribution of Diabetic and Non-Diabetic celiac patients enrolled in the study\u003c/b\u003e\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the statistical analysis of age in different groups of male and female celiac patients (Diabetic and non-Diabetic). No significant difference was recorded among the study group\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAge distribution of Diabetic and Non-Diabetic celiac patients (male and female) enrolled in the study\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAge /year\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNDP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNDP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStd. Error of Mean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStd. Deviation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.17\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMinimum\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaximum\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e0.73 non-sig\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.81 non-sig\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eP value Male vis female diabetic patients: 0.71 non sig\u003c/p\u003e \u003cp\u003eP value Male vis female non diabetic patients 0.58 non sig\u003c/p\u003e \u003cp\u003eP\u0026thinsp;\u0026le;\u0026thinsp;0.05 is considered statically significant\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e: \u003cb\u003eAge distribution of Diabetic and Non-Diabetic celiac patients (male and female) enrolled in the study\u003c/b\u003e\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e shows level of Anti- tissue transglutaminase IgG (IgG-tTG). Significant difference was noticed between the two groups among female celiac patients; being diabetic female patients demonstrated higher levels of Anti-t-IgG, as well as among male patients. Of note, diabetic female exhibited significantly higher levels as compared to male ones; with a similar significance was seen among non-diabetic females and males\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLevels of Anti- tissue transglutaminase IgG (IgG-tTG) among different groups enrolled in the study\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAnti- tTG IgG\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNDP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNDP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e195.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e145.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e111.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e97.76\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStd. Error of Mean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e29.33\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e230.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e83.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStd. Deviation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27.94\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMinimum\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaximum\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e341.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e232.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e312.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e255.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003e0.001 SIG\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.05 SIG\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eP value Male vis female diabetic patients 0.001 SIG\u003c/p\u003e \u003cp\u003eP value Male vis female non diabetic patients 0.001 SIG\u003c/p\u003e \u003cp\u003eP\u0026thinsp;\u0026le;\u0026thinsp;0.05 is considered statically significant\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e: \u003cb\u003eLevels of Anti- tissue transglutaminase IgG (IgG-tTG) among different groups enrolled in the study\u003c/b\u003e\u003c/p\u003e \u003cp\u003eLevel of Anti- tissue transglutaminase IgA (IgA-tTG) antibodies are demonstrated in Table \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. Significant difference was noticed between the two groups among female celiac patients; being diabetic female patients revealed higher levels of IgA-tTG antibodies, but it was not the same case among male patients. While diabetic females exhibited significantly higher levels as compared to male ones, the difference among non-diabetic females and males was not significant\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLevels of Anti- tissue transglutaminase IgA (IgA-tTG) among different groups enrolled in the study\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAnti -tTG IgA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNDP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNDP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e160.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e139.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e113.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e125.27\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStd. Error of Mean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e33.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30.09\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e155.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e57.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStd. Deviation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34.58\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMinimum\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e33.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaximum\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e367.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e331.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e285.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e315.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003e0.01 SIG\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.09 non sig\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eP value Male vis female diabetic patients 0.003 SIG\u003c/p\u003e \u003cp\u003eP value Male vis female non diabetic patients 0.08 non sig\u003c/p\u003e \u003cp\u003eP\u0026thinsp;\u0026le;\u0026thinsp;0.05 is considered statically significant\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e: \u003cb\u003eLevels of Anti- tissue transglutaminase IgA (IgA-tTG) among different groups enrolled in the study\u003c/b\u003e\u003c/p\u003e \u003cp\u003eIn Table \u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e, it is clear that levels of Interferon gamma (IFN-γ) varied significantly between diabetic and non-diabetic groups in female celiac patients; being diabetic female patients revealed higher levels of IFN-γ, and a similar condition was recorded among male patients. Notably, diabetic females showed significantly higher levels as compared to males, but the difference among non-diabetic females and males was not significant\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLevels of Interferon gamma (IFN-γ) among different groups enrolled in the study\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eIFN-γ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNDP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNDP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e76.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47.22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStd. Error of Mean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.37\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStd. Deviation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMinimum\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27.834\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaximum\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e605.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e92.251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e85.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e44.73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003e0.002 SIG\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.05 SIG\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eP value Male vis female diabetic patients 0.05 SIG\u003c/p\u003e \u003cp\u003eP value Male vis female non diabetic patients 0.33 non SIG\u003c/p\u003e \u003cp\u003eP\u0026thinsp;\u0026le;\u0026thinsp;0.05 is considered statically significant\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e: \u003cb\u003eLevels of Interferon gamma (IFN-γ) among different groups enrolled in the study\u003c/b\u003e\u003c/p\u003e \u003cp\u003eIn Table \u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e, there is a highly significant difference in levels of interleukin-1 Bata (IL1β) in both of the females celiac patients groups (diabetics and non-diabetics), with similarity to recorded levels among male patients. Additionally, diabetic females showed significantly higher levels with comparison to males, unlike the difference among non-diabetic females and males\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLevels of interleukin-1 Bata (IL1β) among different groups enrolled in the study\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eIL1β\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNDP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNDP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e452.743\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e136.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e382.347\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e134.245\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStd. Error of Mean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e41.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e625.402\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e114.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e389.061\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e144.66\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStd. Deviation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e84.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e54.28\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMinimum\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e373.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e189.777\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e326.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e185.61\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaximum\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e825.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e471.586\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e986.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e366.99\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003e0.0001 SIG\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.0001 SIG\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eP value Male vis female diabetic patients 0.001 SIG\u003c/p\u003e \u003cp\u003eP value Male vis female non diabetic patients 0.78 non sig\u003c/p\u003e \u003cp\u003eP\u0026thinsp;\u0026le;\u0026thinsp;0.05 is considered statically significant\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e: \u003cb\u003eLevels of interleukin-1 Bata (IL1β) among different groups enrolled in the study\u003c/b\u003e\u003c/p\u003e \u003cp\u003eStatistical correlation among investigated parameters was studied (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e, Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). We considered the total number of Diabetic celiac patients and the correlation among their parameters was explored. Results revealed highly significant positive statistical correlation between IgA-tTG and IgG-tTG Antibodies. Also, IL1β and IFN-γ are correlated with a high statistical significance\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCorrelation among parameters of the Diabetic celiac patients enrolled in the study\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003eCorrelations\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDiabetic patient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIgG-tTG\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIgA-tTG\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eINF- γ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eIL1β\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePearson Correlation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.062\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.037\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.014\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSig. (2-tailed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.780\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.702\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.823\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.931\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eIgG-tTG\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePearson Correlation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.686\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.212\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSig. (2-tailed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.780\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.190\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eIgA-tTG\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePearson Correlation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.062\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.686\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.066\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.026\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSig. (2-tailed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.702\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.684\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.874\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eINF- γ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePearson Correlation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.037\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.066\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.839\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSig. (2-tailed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.823\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.684\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eIL1β\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePearson Correlation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.212\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.839\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSig. (2-tailed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.931\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.190\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.874\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e**. Correlation is significant at the 0.01 level (2-tailed).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e: \u003cb\u003eCorrelation among parameters of the Diabetic celiac patients enrolled in the study\u003c/b\u003e\u003c/p\u003e\u003cp\u003eTable \u003cspan class=\"InternalRef\"\u003e8\u003c/span\u003e (and Fig. \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e) demonstrate correlation among investigated parameters in the total number of Non- Diabetic celiac patients. Unlike the previous one, a negative statistical correlation between IgA-tTG antibodies and IL1\u0026beta; was recorded\u0026nbsp;\u003c/p\u003e\u003ctable id=\"Tab8\" border=\"1\" class=\"fr-table-selection-hover\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eCorrelation among parameters of the Non-Diabetic celiac patients enrolled in the study\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003eCorrelations\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eNon Diabetic patient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eA-T IgG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eA-T IgA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eINF- \u0026gamma;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIL1\u0026beta;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePearson Correlation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026minus;\u0026thinsp;.064\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.198\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026minus;\u0026thinsp;.225\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026minus;\u0026thinsp;.081\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSig. (2-tailed)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.699\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.226\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.169\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.626\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eIgG-tTG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePearson Correlation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026minus;\u0026thinsp;.064\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.057\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.065\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.029\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSig. (2-tailed)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.699\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.726\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.690\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.859\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eIgA-tTG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePearson Correlation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.198\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.057\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026minus;\u0026thinsp;.349\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSig. (2-tailed)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.226\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.726\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.913\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.027\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eINF- \u0026gamma;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePearson Correlation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026minus;\u0026thinsp;.225\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.065\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.025\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSig. (2-tailed)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.169\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.690\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.913\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.879\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003eIL1\u0026beta;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePearson Correlation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026minus;\u0026thinsp;.081\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.029\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026minus;\u0026thinsp;.349\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSig. (2-tailed)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.626\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.859\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.027\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.879\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003e*. Correlation is significant at the 0.05 level (2-tailed).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\n\u003cp\u003eTable \u003cspan class=\"InternalRef\"\u003e8\u003c/span\u003e: \u003cstrong\u003eCorrelation among parameters of the Non-Diabetic celiac patients enrolled in the study\u003c/strong\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eCeliac disease (CD) is a chronic inflammatory intestinal disorder. Different immunological factors, including inflammatory cytokines, may play an important role in disease susceptibility. (Barartabar Z et al \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2018\u003c/span\u003e (\u003c/p\u003e \u003cp\u003eThe prevalence of celiac disease has increased in the last decades, suggesting a role for environmental factors in addition to gluten. (Caminero A et al 2019)\u003c/p\u003e \u003cp\u003eThe manifestations may vary from overt enteropathy to extraintestinal forms, and the symptoms may even be silent (Dahlbom I et al \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2005\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eIn this study, the levels of Anti- tissue transglutaminase IgG (IgG-tTG) were higher in diabetic female celiac patients as compared to non-diabetic ones. Male patients also demonstrated significant difference in the same picture.\u003c/p\u003e \u003cp\u003eWhen we contrast diabetic female with diabetic males, IgG-tTG shows significantly higher levels in the former, with similar difference among female and male non-diabetic celiac patients.\u003c/p\u003e \u003cp\u003eIn the case of Anti- tissue transglutaminase IgA (IgA-tTG) diabetic female celiac patients exhibited significantly higher levels of these antibodies when compared to non-diabetic patients. Unlikely, there was no significant difference among male (diabetic and non-diabetic) celiac patients. However, diabetic females significantly differ from diabetic males regarding those levels, but the difference among non-diabetic females and males was not significant\u003c/p\u003e \u003cp\u003eThese results can be set as an agreement with some records like Kaur N et al. They found that assay format detecting IgA\u0026thinsp;+\u0026thinsp;IgG helped in the detection of potential CD in asymptomatic T1D patients (Kaur N et al \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2019\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eBesides, Lewandowska K reported that tests based on anti-TG IgA are more accurate for detecting CD in children with type 1 diabetes than anti- deamidated gliadin peptide (anti-DGP) IgA (Lewandowska K et al)\u003c/p\u003e \u003cp\u003eThe higher levels of Anti- tissue transglutaminase in diabetic celiac patients may be attributed to the high rate of comorbidities between celiac and diabetes (especially type 1DM).\u003c/p\u003e \u003cp\u003eThe association between CD and T1D was first reported in the late 1960s. The prevalence of CD in patients with T1D is estimated to fall between 1.4% and 19.7%. This comorbidity can largely be attributed to overlapping genetic HLA risk loci; in both conditions, the HLA-DQ2 and DQ8 genes have been shown to be important determinants of disease susceptibility (Serena, G et al \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2015\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAs Interferon gamma (IFN-γ) levels, an important inflammatory indicator, are explored in this study, we noticed significant difference between diabetic and non-diabetic groups in female celiac patients; with clear higher levels of IFN-γ among diabetic female patients, and a similar significance was revealed among male patients. A comparison between diabetic females and males declared significantly higher levels in the former. With no significant difference among non-diabetic females and males resulted.\u003c/p\u003e \u003cp\u003eAnother important inflammatory indicator, interleukin-1 Bata (IL1β), was investigated among the study groups. We can say that the statistical significance here is almost similar to that seen in IFN-γ case\u003c/p\u003e \u003cp\u003eThere is evidence that cytokines, in particular interleukin-1 beta (IL1β) and interferon-gamma (IFN-gamma) might mediate beta cell destruction in type 1 diabetes. (Ciampolillo A et al \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e1993\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eIt is well known that there is a harmony effect of inflammatory process in various autoimmune diseases. CD arises in genetically susceptible individuals with HLA-DQ2 or HLA-DQ8 alleles and is characterized by a T-cell-driven inflammation in the proximal small bowel triggered by gluten ingestion. Gluten is delivered to TCD4\u0026thinsp;+\u0026thinsp;cell and activates them causing the secretion of different pro-inflammatory and inflammatory cytokines such as interferon (IFN)-γ, interleukin IL-1, IL-6, IL-8, and others. After this event, TCD4\u0026thinsp;+\u0026thinsp;cell interaction with B cells leads to the release of autoantibodies such as anti-tissue transglutaminase (tTG) and DGA (Deamidated gliadin antibody) which is a marker for active disease.\u003c/p\u003e \u003cp\u003eThe IL-1 family consists of 11 cytokines and has been also expanded to 9 distinct genes that have emerged as a therapeutic mark for auto-inflammatory diseases such as CD. IL-1α and IL-1β have highly inflammatory effects, and have been evaluated in various studies. Some studies recorded elevated serum IL-1 and IL-1β which was associated with increased CD and its symptoms (Nasserinejad M et al \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), making it consistent with our results.\u003c/p\u003e \u003cp\u003eHence, the role of IFN-γ and IL1β in diabetic celiac patients becomes clear if this study\u0026rsquo;s results are considered.\u003c/p\u003e \u003cp\u003eTo test the correlation among the studied parameters in diabetic celiac patients, a highly significant positive statistical correlation between IgA-tTG and IgG-tTG Antibodies was found, as well as that between IL1β and IFN-γ\u003c/p\u003e \u003cp\u003eThis means that as one of the correlated parameters increases, the corresponding one increases and vice versa. Given those finding, more confirmation is achieved regarding the profound inflammatory process encountered in such autoimmune diseases.\u003c/p\u003e \u003cp\u003eOn the contrary, in non- diabetic celiac patients a negative statistical correlation between IgA-tTG and IL1β resulted. This refers to an inverse relation between them in such patients.\u003c/p\u003e \u003cp\u003eIn general, the widely accepted concept of higher incidence of autoimmune diseases in females as compared to males can explain the significantly higher results in females in this study\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eInflammatory cytokines like IFN-γ and IL1β are important factors in both pathogenesis and development of symptoms in celiac diseases, and this may vary clearly when comorbidities are accompanying celiac; as diabetes mellitus.\u003c/p\u003e \u003cp\u003eA comprehensive interpretation of the inflammatory profile of CD in different metabolic contexts may support the development of novel therapeutic strategies for the management of CD and related disorders.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank Mrs. Dalya Falah Hassan (MSc Microbiology) and the staff of the Specialized Centre of Endocrinology and Diabetes - Rusafa / Baghdad - Iraq; the manager and Dr. Asma Ghalib Abid (M.B.Ch.B, M.Sc, F.I.C.M.S / path.immune) for their valuable contributions and support\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that no funds, grants, or other support were received during the preparation of this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no relevant financial or non-financial interests to disclose.\u003c/p\u003e\n\u003cp\u003eThe authors have no competing interests to declare that are relevant to the content of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors contributed to the study conception and design. Material preparation, data collection and analysis, examining the patients and selecting those who meet the inclusion criteria and laboratory work were performed by: Hind Suhail Ali, Asaad F. Albayati, Nameer Mahdi Salih, Iftikhar Khawwam and Abdulrahman Shakir Abd. The first draft of the manuscript was written by Asaad F. Albayati and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript\u003cspan dir=\"RTL\"\u003e.\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e \u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eEthics approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted under the approval granted by the Ethical approval Committee of College of Medicine/ Al-Iraqia University\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eConsent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from the parents.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAl-Toma A, Volta U, Auricchio R, Castillejo G, Sanders DS, Cellier C, Mulder CJ, Lundin KEA (2019) European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterol J 7:583-613. https://doi.org/10.1177/2050640619844125\u003c/li\u003e\n\u003cli\u003eBarartabar Z, Nikzamir A, Sirati-Sabet M, Aghamohammadi E, Chaleshi V, Rostami Nejad M, Asadzadeh-Aghdaei H, Reza Zali M (2018) The relationship between 174 G/C and -572 G/C of IL-6 gene polymorphisms and susceptibility of celiac disease in the Iranian population. Prz Gastroenterol 13:293-298. https://doi.org/10.5114/pg.2018.79808\u003c/li\u003e\n\u003cli\u003eCaminero A, Verdu EF (2019) Celiac disease: should we care about microbes? Am J Physiol Gastrointest Liver Physiol 317:G161-G170. https://doi.org/10.1152/ajpgi.00099.2019\u003c/li\u003e\n\u003cli\u003eCiampolillo A, Guastamacchia E, Caragiulo L, Lollino G, De Robertis O, Lattanzi V, Giorgino R (1993) In vitro secretion of interleukin-1 beta and interferon-gamma by peripheral blood lymphomononuclear cells in diabetic patients. Diabetes Res Clin Pract 21:87-93. https://doi.org/10.1016/0168-8227(93)90054-9\u003c/li\u003e\n\u003cli\u003eDahlbom I, Olsson M, Forooz NK, Sj\u0026ouml;holm AG, Truedsson L, Hansson T (2005) Immunoglobulin G (IgG) anti-tissue transglutaminase antibodies used as markers for IgA-deficient celiac disease patients. Clin Diagn Lab Immunol 12:254-258. https://doi.org/10.1128/CDLI.12.2.254-258.2005\u003c/li\u003e\n\u003cli\u003eFlores Monar GV, Islam H, Puttagunta SM, Islam R, Kundu S, Jha SB, Rivera AP, Sange I (2022) Association Between Type 1 Diabetes Mellitus and Celiac Disease: Autoimmune Disorders With a Shared Genetic Background. Cureus 14:e22912. https://doi.org/10.7759/cureus.22912\u003c/li\u003e\n\u003cli\u003eHill ID, Fasano A, Guandalini S, Hoffenberg E, Levy J, Reilly N, Verma R (2016) NASPGHAN Clinical Report on the Diagnosis and Treatment of Gluten-related Disorders. J Pediatr Gastroenterol Nutr 63:156-165. https://doi.org/10.1097/MPG.0000000000001216\u003c/li\u003e\n\u003cli\u003eKaur N, Minz RW, Bhadada SK, et al (2019) Role of anti-tissue transglutaminase IgA+IgG antibodies in detection of potential celiac disease in patients with type 1 diabetes. Indian J Med Res 149:18-25. https://doi.org/10.4103/ijmr.IJMR_1136_16\u003c/li\u003e\n\u003cli\u003eLewandowska K, Ciepiela O, Szypowska A, Wyhowski J, Głodkowska-Mr\u0026oacute;wka E, Popko K, Ostafin M, Pyrżak B, Demkow U (2018) Celiac antibodies in children with type 1 diabetes - A diagnostic validation study. Autoimmunity 51:81-88. https://doi.org/10.1080/08916934.2018.1427226\u003c/li\u003e\n\u003cli\u003eLudvigsson JF, Leffler DA, Bai JC, et al (2013) The Oslo definitions for coeliac disease and related terms. Gut 62:43-52. https://doi.org/10.1136/gutjnl-2011-301346\u003c/li\u003e\n\u003cli\u003eManavalan JS, Hernandez L, Shah JG, Konikkara J, Naiyer AJ, Lee AR, Ciaccio E, Minaya MT, Green PH, Bhagat G (2010) Serum cytokine elevations in celiac disease: association with disease presentation. Hum Immunol 71:50-57. https://doi.org/10.1016/j.humimm.2009.09.351\u003c/li\u003e\n\u003cli\u003eNasserinejad M, Shojaee S, Ghobakhlou M, Lak E, Eslami P, Pourhoseingholi MA (2019) The effects of IL-8, IL-6, and IL-1 on the risk of celiac disease: a Bayesian regression analysis. Gastroenterol Hepatol Bed Bench 12:S117-S122. PMID: 32099611; PMCID: PMC7011063\u003c/li\u003e\n\u003cli\u003eNilsen EM, Lundin KE, Krajci P, Scott H, Sollid LM, Brandtzaeg P (1995) Gluten specific, HLA-DQ restricted T cells from coeliac mucosa produce cytokines with Th1 or Th0 profile dominated by interferon gamma. Gut 37:766-776. https://doi.org/10.1136/gut.37.6.766\u003c/li\u003e\n\u003cli\u003eSerena G, Camhi S, Sturgeon C, Yan S, Fasano A (2015) The Role of Gluten in Celiac Disease and Type 1 Diabetes. Nutrients 7:7143-7162. https://doi.org/10.3390/nu7095329\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Al-Iraqia University / College of Medicine","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Autoimmune diseases, celiac disease, comorbidity, diabetes mellitus, inflammatory cytokines, IFN-γ, IL-1β","lastPublishedDoi":"10.21203/rs.3.rs-6617269/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6617269/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eCeliac disease (CD) is a chronic autoimmune disorder characterized by a noxious immune response to gluten in genetically susceptible persons. CD has a coincidence with diabetes mellitus, particularly type 1 diabetes, due to shared genetic risk factors and autoimmune mechanisms.\u003c/p\u003e\u003ch2\u003eAim\u003c/h2\u003e \u003cp\u003eThis study aims to test the levels of IFN-γ and IL-1β in diabetic and non-diabetic Celiac patients, and to explore the relationship between these cytokines and disease activity.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eEighty children with CD (diabetic and non-diabetic) were enrolled in this study. Serum levels of anti- tissue transglutaminase IgG (IgG-tTG) and IgA (IgA-tGA), IFN-γ and IL-1β were measured using ELISA, and statistical analysis was performed to compare the levels of these cytokines between the two groups.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe results revealed significantly higher levels of IFN-γ and IL-1β in diabetic celiac patients compared to non-diabetic ones. Females showed higher levels of these cytokines compared to males. Of note, a positive correlation was found between IL-1β and IFN-γ in diabetic celiac patients.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe study highlights the importance of inflammatory cytokines like IFN-γ and IL-1β in the pathogenesis and development of symptoms in CD, particularly in the context of comorbidities like diabetes mellitus. Understanding the inflammatory profile of CD in different metabolic contexts may support the management.\u003c/p\u003e","manuscriptTitle":"Variations of interleukin (IL) 1 Beta (IL 1 β) and interferon gamma (INF-Ɣ) in Diabetic and Non-Diabetic Celiac Patients","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-16 12:20:00","doi":"10.21203/rs.3.rs-6617269/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6070fddf-65c6-4abd-8545-ce08e3f3e07d","owner":[],"postedDate":"May 16th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":48579448,"name":"Immunology"}],"tags":[],"updatedAt":"2025-05-16T12:20:00+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-16 12:20:00","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6617269","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6617269","identity":"rs-6617269","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}