Department of Pediatrics, DISM, University of Udine, Piazzale Santa Maria Delle Misericordia 15, Udine, Italy.
Eur J Gastroenterol Hepatol. 2012 Jan;24(1):59-63. doi: 10.1097/MEG.0b013e32834d09d4.
To determine the genetic profile of celiac disease (CD) in Libyan children with type 1 diabetes as there are no data on the frequency of human leukocyte antigen (HLA)-related CD-predisposing genes in diabetic patients in Libya.
We randomly studied 218 Libyan type 1 diabetic children. The mean age was 12.2±4.6 years; 56% were female patients. The mean duration of diabetes was 4.7±4.0 years. All patients were screened for CD with IgA tissue-transglutaminase (tTG) and endomysium antibodies. Patients with positive immunological screen were programmed for a small-bowel biopsy. HLA-DRB1* and HLA-DQB1* were genotyped in all tTG-positive patients.
Twenty-seven (12.4%) out of 218 patients with type1 diabetes had positive tTG, and 20 (9.2%) of these patients were positive for endomysium antibodies. Five patients (5/27) were already known cases of biopsy-proven CD. Biopsy was not performed in two patients. One biopsy result was normal, whereas 19 biopsies demonstrated morphological changes consistent with CD. Forty-eight percent of the anti-tTG-positive group were homozygous for HLA-DQ2, whereas 75% of biopsy-proven CD patients had HLA-DQ2, 21% had HLA-DQ2/DQ8, and 4% had HLA-DQ8. In addition, the majority (70%) carried HLA-DQ2 linkage with HLA-DRB1*03.
Overall, biopsy-confirmed prevalence of CD was 11% (24 of 218). The present study confirms that CD in the Libyan type 1 diabetic population is high when compared with European and US studies, and for the first time we document that this population shares similar HLA-DQ2 genotype. This supports the theory regarding the role of the environment as an important factor in CD development in this part of the world.
确定利比亚 1 型糖尿病儿童中乳糜泻（CD）的遗传特征，因为利比亚尚无关于糖尿病患者人类白细胞抗原（HLA）相关 CD 易感基因频率的数据。
我们随机研究了 218 名利比亚 1 型糖尿病儿童。平均年龄为 12.2±4.6 岁；56%为女性患者。糖尿病的平均病程为 4.7±4.0 年。所有患者均接受 IgA 组织转谷氨酰胺酶（tTG）和内肌层抗体的 CD 免疫筛查。免疫筛查阳性的患者计划进行小肠活检。所有 tTG 阳性患者均进行 HLA-DRB1和 HLA-DQB1基因分型。
218 例 1 型糖尿病患者中，27 例（12.4%）tTG 阳性，其中 20 例（9.2%）患者内肌层抗体阳性。5 例（5/27）患者为已确诊的活检证实 CD 病例。有 2 例患者未进行活检。1 例活检结果正常，而 19 例活检显示符合 CD 的形态学改变。抗 tTG 阳性组中，48%为 HLA-DQ2 纯合子，而活检证实 CD 患者中，75%为 HLA-DQ2，21%为 HLA-DQ2/DQ8，4%为 HLA-DQ8。此外，大多数（70%）患者携带与 HLA-DRB1*03 相关的 HLA-DQ2 连锁。
总的来说，活检证实的 CD 患病率为 11%（218 例中有 24 例）。本研究证实，与欧洲和美国的研究相比，利比亚 1 型糖尿病人群中的 CD 患病率较高，并且我们首次证明该人群具有相似的 HLA-DQ2 基因型。这支持了环境作为该地区 CD 发展的重要因素的理论。
