Metzger Marie-Hélène, Heier Margit, Mäki Markku, Bravi Enzo, Schneider Andrea, Löwel Hannelore, Illig Thomas, Schuppan Detlef, Wichmann Heinz-Erich
GSF - National Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Germany.
Eur J Epidemiol. 2006;21(5):359-65. doi: 10.1007/s10654-006-9002-4. Epub 2006 Apr 29.
Immunoglobulin A (IgA) autoantibodies to tissue transglutaminase (tTG) are commonly used for screening and diagnosing of celiac disease. We examined the hypothesis that elevated IgA anti-tTG antibodies were associated with higher all-cause mortality risk.
The cohort, 2333 men and 2300 women, was based on the follow-up of participants of a representative population-based survey in Southern Germany (KORA/MONICA Augsburg project) conducted in 1989-1990. The endpoint for the vital status with cause of death was the year 1998. The sera drawn at baseline and stored at -80 degrees C, were recently screened with an IgA enzyme-linked immunosorbent assay (ELISA) using human recombinant tTG. Age-standardized mortality rates and age-adjusted hazard ratios were calculated.
From the 4633 sera analyzed, 63 had an IgA anti-tTG concentration>or=7 AU/ml. Of these 63 individuals, 15 died between 1989 and 1998. The age-adjusted hazard ratio (HRa) of all-cause mortality was 1.86 (95% CI: 1.01-3.41) and 3.92 (95% CI: 1.44-10.71) for men and women, respectively. The excess of cancer mortality was even higher with an HR(a) of 2.47 (95% CI: 0.89-6.83) in men and of 6.65 (95% CI: 2.04-21.63) in women.
Individuals with elevated IgA anti-tTG antibodies had a highly increased mortality risk, particularly due to cancer. New studies are necessary to clarify if this increased risk is due to undiagnosed celiac disease or/and if this elevated IgA anti-tTG antibodies level is a marker of serious diseases like cancer, chronic liver disease or end-stage heart failure.
抗组织转谷氨酰胺酶（tTG）的免疫球蛋白A（IgA）自身抗体常用于筛查和诊断乳糜泻。我们检验了以下假设：IgA抗tTG抗体升高与全因死亡风险增加相关。
该队列包括2333名男性和2300名女性，基于对1989 - 1990年在德国南部进行的一项具有代表性的基于人群的调查（KORA/MONICA奥格斯堡项目）参与者的随访。死亡原因的生命状态终点为1998年。在基线时采集并储存在 -80℃的血清，最近使用人重组tTG通过IgA酶联免疫吸附测定（ELISA）进行筛查。计算年龄标准化死亡率和年龄调整风险比。
在分析的4633份血清中，63份的IgA抗tTG浓度≥7 AU/ml。在这63个人中，15人在1989年至1998年期间死亡。男性和女性全因死亡的年龄调整风险比（HRa）分别为1.86（95%CI：1.01 - 3.41）和3.92（95%CI：1.44 - 10.71）。癌症死亡率的超额风险更高，男性的HR(a)为2.47（95%CI：0.89 - 6.83），女性为6.65（95%CI：2.04 - 21.63）。
IgA抗tTG抗体升高的个体死亡风险大幅增加，尤其是因癌症导致的风险。有必要开展新的研究以阐明这种风险增加是由于未诊断的乳糜泻，还是/并且这种升高的IgA抗tTG抗体水平是癌症、慢性肝病或终末期心力衰竭等严重疾病的标志物。
