Research Unit, at Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain.
Immunol Lett. 2012 Sep;147(1-2):63-6. doi: 10.1016/j.imlet.2012.06.004. Epub 2012 Jul 4.
The presence in serum of parietal cell autoantibodies (PCA) is a characteristic of autoimmune gastritis. We determined the prevalence of PCA in the general population and investigate their association with type 2 diabetes, insulin resistance and lifestyle factors related with autoimmune gastritis. A cross-sectional study was performed, involving 429 individuals enrolled in a cohort study of the general population of the Canary Islands. All participants underwent physical examination, provided a blood sample and responded to a questionnaire regarding health and lifestyle factors. Serum concentrations of PCA, soluble CD40 ligand (sCD40L), C-peptide and glucose (to determine insulin resistance) were measured. The association of PCA with the other factors was determined with bivariate analysis, and logistic regression models were used to adjust the associations for age and sex. The prevalence of PCA was 7.8% (95% CI=10.3-5.3). The factors associated with PCA were female sex (p=0.032), insulin resistance (p=0.016), menopause (p=0.029) and sCD40L (p=0.019). Alcohol consumption (p=0.006) and smoking (p=0.005) were associated with low prevalences of PCA. After adjustment for age and sex, the association with PCA was confirmed for smoking (OR=0.1 [0.0-0.9]), alcohol consumption (OR=0.3 [0.1-0.9]), insulin resistance (OR=2.4 [1.1-4.9]), female sex (OR=2.4 [1.1-5.3]), sCD40L (OR=3.7 [1.2-11.4]) and menopause (OR=5.3 [1.2-23.3]). In conclusion, smoking and alcohol consumption acted as protective factors against the appearance of PCA in the general population, whereas female sex, menopause, insulin resistance and elevated serum sCD40L were risk markers for PCA. In patients who smoke or drink alcohol, clinicians should be cautious when using PCA to rule out autoimmune gastritis.
血清壁细胞自身抗体(PCA)的存在是自身免疫性胃炎的特征。我们确定了 PCA 在普通人群中的患病率,并研究了其与 2 型糖尿病、胰岛素抵抗以及与自身免疫性胃炎相关的生活方式因素的关系。进行了一项横断面研究,纳入了参加加那利群岛一般人群队列研究的 429 名个体。所有参与者都接受了体格检查,提供了血液样本,并回答了关于健康和生活方式因素的问卷。测量了血清 PCA、可溶性 CD40 配体(sCD40L)、C 肽和葡萄糖(以确定胰岛素抵抗)的浓度。使用双变量分析确定 PCA 与其他因素的关联,并使用逻辑回归模型调整年龄和性别对关联的影响。PCA 的患病率为 7.8%(95%CI=10.3-5.3)。与 PCA 相关的因素为女性(p=0.032)、胰岛素抵抗(p=0.016)、绝经(p=0.029)和 sCD40L(p=0.019)。饮酒(p=0.006)和吸烟(p=0.005)与 PCA 的低患病率相关。在调整年龄和性别后,吸烟(OR=0.1 [0.0-0.9])、饮酒(OR=0.3 [0.1-0.9])、胰岛素抵抗(OR=2.4 [1.1-4.9])、女性(OR=2.4 [1.1-5.3])、sCD40L(OR=3.7 [1.2-11.4])和绝经(OR=5.3 [1.2-23.3])与 PCA 之间的关联得到确认。总之,吸烟和饮酒是普通人群中 PCA 出现的保护因素,而女性、绝经、胰岛素抵抗和血清 sCD40L 升高是 PCA 的危险因素。在吸烟或饮酒的患者中,临床医生在使用 PCA 排除自身免疫性胃炎时应谨慎。