Shibata Minoru, Onozuka Yasushi, Morizane Toshio, Koizumi Hideko, Kawaguchi Naomi, Miyakawa Hiroshi, Kako Makoto, Mitamura Keiji
Department of Gastroenterology, Kanto Medical Center, NTT EC (Nippon Telegraph and Telephone East Corporation), Tokyo, Japan.
J Gastroenterol. 2004;39(3):255-9. doi: 10.1007/s00535-003-1285-6.
The prevalence of antimitochondrial antibody (AMA) in humans and its relationship to the development of primary biliary cirrhosis (PBC) are not well known. We have estimated the frequency of AMA in the general population, and studied its association with PBC.
We studies 1714 corporate workers (median age, 48 years; range, 30 to 59 years) who had an annual health check from 1998 to 1999 at Kawasaki Social Insurance Hospital in Japan. We used an indirect immunofluorescence method for screening serum AMA. We applied the prevalence of AMA-positive people in the study group to the general population in Japan. Then the inferred AMA-positive population was compared to the actual number of patients with PBC in statistics published by the Japanese Government.
AMA was detected in 11 of 1714 people (0.64%; 95% confidence interval, 0.26% to 1.02%). All these 11 sera reacted with 2-oxoacid-dehydrogenase complex by immunoblotting. Of these 11 individuals, none had subjective symptoms, all had normal serum bilirubin levels, and 6 had abnormal liver function test results. Using published statistics for the Japanese population, we inferred that there were approximately 336,472 AMA-positive people in Japan from age 30 to 59 years. The number of patients with symptomatic PBC recorded by the nationwide epidemiological survey of the Japanese Government was 2459. Thus, we inferred the rate of symptomatic PBC among AMA-positive persons to be about 0.73% (2459/336,472).
AMA is not a rare antibody in the general population, but few people develop recognizable PBC even if they have AMA.
人类抗线粒体抗体(AMA)的流行情况及其与原发性胆汁性肝硬化(PBC)发生发展的关系尚不清楚。我们估算了普通人群中AMA的频率,并研究了其与PBC的关联。
我们研究了1998年至1999年在日本川崎社会保险医院进行年度健康检查的1714名公司员工(中位年龄48岁;范围30至59岁)。我们采用间接免疫荧光法筛查血清AMA。我们将研究组中AMA阳性人群的患病率应用于日本普通人群。然后将推断出的AMA阳性人群与日本政府公布的统计数据中PBC患者的实际人数进行比较。
1714人中11人检测到AMA(0.64%;95%置信区间,0.26%至1.02%)。通过免疫印迹法,所有这11份血清均与2-氧代酸脱氢酶复合物发生反应。这11人中,无人有主观症状,所有人血清胆红素水平均正常,6人肝功能检查结果异常。利用日本人群的公开统计数据,我们推断日本30至59岁的AMA阳性人群约有336,472人。日本政府全国流行病学调查记录的有症状PBC患者人数为2459人。因此,我们推断AMA阳性者中有症状PBC的发生率约为0.73%(2459/336,472)。
AMA在普通人群中并非罕见抗体,但即使有AMA,很少有人会发展为可识别的PBC。