Rodríguez-Ventura Ana L, Yamamoto-Furusho Jesus K, Coyote Ninel, Dorantes Luis M, Ruiz-Morales Jorge A, Vargas-Alarcón Gilberto, Granados Julio
Department of Pediatric Endocrinology, Hospital Infantil de México, Mexico City, Mexico.
Pediatr Diabetes. 2007 Feb;8(1):5-10. doi: 10.1111/j.1399-5448.2006.00221.x.
It may be difficult to distinguish type 1 diabetes mellitus (T1DM) from type 2 diabetes mellitus (T2DM) in the pediatric population. Autoantibodies may help to differentiate both types of diabetes, but sometimes these are positive in patients with T2DM and negative in patients with T1DM. The human leukocyte antigen (HLA)-DR genotype has been associated with T1DM and with T2DM only in adults and in determined cases.
To determine the differences in HLA class II allele frequencies in Mexican children with T1DM and T2DM.
We included 72 children with T1DM, 28 children with T2DM, and 99 healthy controls. All were Mexican, and diabetes was diagnosed according to the clinical and laboratory criteria established by the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. The HLA-DRB1 typing was performed using polymerase chain reaction-sequence-specific oligonucleotide probe and polymerase chain reaction sequence-specific primers.
We found an increased frequency of HLA-DRB108 and a decreased frequency of HLA-DRB104 in the group with T2DM vs. T1DM [p = 0.0001, odds ratio (OR) = 10.58, 95% confidence interval (CI) = 3-40.8 and p = 0.0006, OR = 0.24, 95% CI = 0.11-0.53, respectively]. No significant differences were found between HLA-DRB1 alleles in T2DM vs. controls. In the group with T1DM, there was a significantly increased frequency of the HLA-DR4 and HLA-DR3 alleles relative to controls (p = 0.0000001, OR = 3.59, 95% CI = 2.2-5.8 and p = 0.00009, OR = 4.66, 95% CI = 2.1-10.3, respectively).
There are significant differences in the HLA profile in Mexican children with T1DM and T2DM. HLA typing could play a role in the differentiation between both types of diabetes in this population.
在儿科人群中，区分1型糖尿病（T1DM）和2型糖尿病（T2DM）可能存在困难。自身抗体可能有助于区分这两种类型的糖尿病，但有时T2DM患者的自身抗体呈阳性，而T1DM患者的自身抗体呈阴性。人类白细胞抗原（HLA）-DR基因型仅在成人及特定病例中与T1DM和T2DM相关。
确定墨西哥T1DM和T2DM儿童中HLA II类等位基因频率的差异。
我们纳入了72例T1DM儿童、28例T2DM儿童和99例健康对照。所有受试者均为墨西哥人，糖尿病根据糖尿病诊断与分类专家委员会制定的临床和实验室标准进行诊断。采用聚合酶链反应-序列特异性寡核苷酸探针和聚合酶链反应序列特异性引物进行HLA-DRB1分型。
我们发现，与T1DM组相比，T2DM组中HLA-DRB108频率增加，HLA-DRB104频率降低[p = 0.0001，优势比（OR）= 10.58，95%置信区间（CI）= 3 - 40.8；p = 0.0006，OR = 0.24，95% CI = 0.11 - 0.53]。T2DM组与对照组之间的HLA-DRB1等位基因无显著差异。在T1DM组中，相对于对照组，HLA-DR4和HLA-DR3等位基因频率显著增加（分别为p = 0.0000001，OR = 3.59，95% CI = 2.2 - 5.8；p = 0.00009，OR = 4.66，95% CI = 2.1 - 10.3）。
墨西哥T1DM和T2DM儿童的HLA谱存在显著差异。HLA分型可能在该人群中两种类型糖尿病的鉴别中发挥作用。
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