Zanella Sara, De Leo Luigina, Nguyen-Ngoc-Quynh Le, Nguyen-Duy Bo, Not Tarcisio, Tran-Thi-Chi Mai, Phung-Duc Son, Le-Thanh Hai, Malaventura Cristina, Vatta Serena, Ziberna Fabiana, Mazzocco Martina, Volpato Stefano, Phung-Tuyet Lan, Le-Thi-Minh Huong, Borgna-Pignatti Caterina
Department of Medical Sciences/Pediatrics, University of Ferrara, Ferrara, Italy.
Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy.
BMJ Open. 2016 Jun 21;6(6):e011173. doi: 10.1136/bmjopen-2016-011173.
The prevalence of coeliac disease (CD) in Vietnam is unknown. To fill this void, we assessed the prevalence of serological markers of CD autoimmunity in a population of children in Hanoi.
The outpatient blood drawing laboratory of the largest paediatric hospital in North Vietnam was used for the study, which was part of an international project of collaboration between Italy and Vietnam.
Children having blood drawn for any reason were included. Exclusion criteria were age younger than 2 years, acquired or congenital immune deficiency and inadequate sample. A total of 1961 children (96%) were enrolled (838 females, 1123 males, median age 5.3 years).
Primary outcome was the prevalence of positive autoimmunity to both IgA antitransglutaminase antibodies (anti-tTG) assessed with an ELISA test and antiendomysial antibodies (EMA). Secondary outcome was the prevalence of CD predisposing human leucocyte antigens (HLA) (HLA DQ2/8) in the positive children and in a random group of samples negative for IgA anti-tTG.
The IgA anti-tTG test was positive in 21/1961 (1%; 95% CI 0.61% to 1.53%); however, EMA antibodies were negative in all. HLA DQ2/8 was present in 7/21 (33%; 95% CI 14.5% to 56.9%) of the anti-tTG-positive children and in 72/275 (26%; 95% CI 21% to 32%) of those who were negative.
Coeliac autoimmunity is rare in Vietnam, although prevalence of HLA DQ2/8 is similar to that of other countries. We hypothesise that the scarce exposure to gluten could be responsible for these findings.
越南乳糜泻（CD）的患病率尚不清楚。为填补这一空白，我们评估了河内儿童群体中CD自身免疫血清学标志物的患病率。
研究采用了越南北部最大的儿科医院的门诊采血实验室，该研究是意大利和越南国际合作项目的一部分。
纳入因任何原因进行采血的儿童。排除标准为年龄小于2岁、获得性或先天性免疫缺陷以及样本不足。共纳入1961名儿童（96%）（838名女性，1123名男性，中位年龄5.3岁）。
主要结果是通过酶联免疫吸附测定（ELISA）检测的抗麦胶蛋白转谷氨酰胺酶抗体（抗tTG）和抗肌内膜抗体（EMA）自身免疫阳性的患病率。次要结果是阳性儿童以及随机抽取的抗tTG阴性样本组中CD易感人类白细胞抗原（HLA）（HLA DQ2/⑧）的患病率。
1961例中抗tTG IgA检测阳性21例（1%；95%可信区间0.61%至1.53%）；然而，所有EMA抗体均为阴性。抗tTG阳性儿童中7/21（33%；95%可信区间14.5%至56.9%）存在HLA DQ2/⑧，抗tTG阴性者中72/275（26%；95%可信区间21%至32%）存在HLA DQ2/⑧。
在越南，乳糜泻自身免疫较为罕见，尽管HLA DQ2/⑧的患病率与其他国家相似。我们推测，麸质暴露不足可能是这些结果的原因。
