De Block C E, De Leeuw I H, Rooman R P, Winnock F, Du Caju M V, Van Gaal L F
Department of Endocrinology-Diabetology, University Hospital Antwerp, Edegem, Belgium.
Diabet Med. 2000 Aug;17(8):618-22. doi: 10.1046/j.1464-5491.2000.00354.x.
To assess the prevalence of thyrogastric autoimmunity in relation to age, sex, beta-cell antibody status and HLA DQ haplotypes in Type 1 diabetes mellitus.
One hundred and seventy-one patients with Type 1 diabetes mellitus were studied (male/female 86/85; mean age 19 +/- 11 years; duration of diabetes 5 +/- 4 years). Islet cell antibodies (ICA) and parietal cell antibodies (PCA) were measured using indirect immunofluorescence; glutamic acid decarboxylase-65 antibodies (GADA) by radiobinding assay and thyroid peroxidase antibodies (TPO) with an immunoradiometric assay (IRMA).
The majority of subjects (81.3%) showed one or more autoantibodies. The prevalence rates were: GADA 64.9%, ICA 46.2%, PCA 19.9% and TPO 19.3%. Patients with ICA+ > or = 3 years after diagnosis had a higher prevalence of GADA (P = 0.03, odds ratio (OR) 2.66) and thyrogastric antibodies (P = 0.05, OR 2.23) than subjects ICA- after 3 years. PCA+ patients were older (P = 0.04), had a higher prevalence of GADA (P = 0.005, OR 3.89) and TPO (P = 0.05, OR 2.50) than PCA- subjects. Logistic regression analysis showed that PCA status was determined by the HLA DQA10501-DQB10301 haplotype (beta = 2.94, P = 0.04) and GADA status (beta = 2.44, P = 0.041).
Thyrogastric antibodies are highly prevalent in Type 1 diabetes mellitus, especially in patients with persisting ICA. Screening for gastric autoimmunity is particularly advised in patients who are positive for GADA and for the HLA DQA10501-DQB10301 haplotype.
评估1型糖尿病患者中甲状腺和胃自身免疫与年龄、性别、β细胞抗体状态及HLA DQ单倍型的相关性。
对171例1型糖尿病患者进行研究（男/女86/85；平均年龄19±11岁；糖尿病病程5±4年）。采用间接免疫荧光法检测胰岛细胞抗体（ICA）和壁细胞抗体（PCA）；采用放射结合法检测谷氨酸脱羧酶-65抗体（GADA），采用免疫放射分析法（IRMA）检测甲状腺过氧化物酶抗体（TPO）。
大多数受试者（81.3%）显示一种或多种自身抗体。患病率分别为：GADA 64.9%、ICA 46.2%、PCA 19.9%和TPO 19.3%。诊断后ICA+≥3年的患者GADA患病率（P = 0.03，优势比（OR）2.66）和甲状腺及胃抗体患病率（P = 0.05，OR 2.23）高于3年后ICA-的受试者。PCA+患者年龄较大（P = 0.04），GADA患病率（P = 0.005，OR 3.89）和TPO患病率（P = 0.05，OR 2.50）高于PCA-受试者。逻辑回归分析显示，PCA状态由HLA DQA10501-DQB10301单倍型（β = 2.94，P = 0.04）和GADA状态（β = 2.44，P = 0.041）决定。
甲状腺和胃抗体在1型糖尿病中高度流行，尤其是在持续性ICA患者中。对于GADA阳性和HLA DQA10501-DQB10301单倍型的患者，特别建议筛查胃自身免疫。
