Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Thailand.
Center of Excellence in Immunology and Immune-mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University.
Asian Pac J Allergy Immunol. 2017 Jun;35(2):82-85. doi: 10.12932/AP0751.
Patients with type 1 diabetes mellitus (T1DM) have an increased risk of celiac disease (CD). Both diseases have a common genetic susceptibility locus in the human leukocyte antigen (HLA) class II alleles. Testing for tissue transglutaminase antibodies (anti-tTG) is highly accurate for a CD diagnosis.
To determine the frequency of HLA-DQB10201/02 and DQB10302 alleles and anti-tTG seropositivity in children with T1DM.
Forty-six children with T1DM (male:female=24:22; mean age 12±3.7 years) without significant digestive symptoms were enrolled. The mean duration of diabetes was 5±3.5 years. Serum anti-tTG IgA and IgG as well as HLA-DQ2 (DQB10201/02) and -DQ8 (DQB10302) alleles were analyzed. The allele frequencies were compared with those in controls, which included 124 normal Thai individuals, as reported in our previous study.
All subjects were negative for anti-tTG IgG. Only one patient (2.2%) was positive for anti-tTG IgA (38.5 U/mL; cut-off 15 U/mL). Although this patient was also heterozygous for HLA-DQ2 and was asymptomatic for CD, he declined endoscopic confirmation. Twenty-nine of 46 patients carried HLA-DQ2 and/or -DQ8 heterodimers. HLA-DQB10201/02 and HLA-DQB10302 allele frequencies were significantly higher (27% and 14%) in T1DM patients compared with normal controls (13.3% and 7.3%; P<0.001 and P=0.002, respectively).
A significantly greater frequency of DQB10201/02 and DQB10302 alleles were present in children with T1DM compared with the control group. This indicates a potentially important role of these alleles in the development of T1DM. The prevalence of CD screening by serologic testing is negligible in Thai children with T1DM.
1 型糖尿病（T1DM）患者患乳糜泻（CD）的风险增加。这两种疾病在人类白细胞抗原（HLA）II 类等位基因中都有一个共同的遗传易感性位点。组织转谷氨酰胺酶抗体（抗 tTG）检测对 CD 的诊断具有高度准确性。
确定 T1DM 患儿 HLA-DQB10201/02 和 DQB10302 等位基因及抗 tTG 血清阳性率。
纳入 46 例无明显消化道症状的 T1DM 患儿（男：女=24:22；平均年龄 12±3.7 岁）。糖尿病的平均病程为 5±3.5 年。分析血清抗 tTG IgA 和 IgG 以及 HLA-DQ2（DQB10201/02）和-DQ8（DQB10302）等位基因。将等位基因频率与我们之前研究中报道的 124 例正常泰国个体的对照进行比较。
所有患者的抗 tTG IgG 均为阴性。仅有 1 例患者（2.2%）抗 tTG IgA 阳性（38.5 U/mL；截断值 15 U/mL）。尽管该患者还携带有 HLA-DQ2，且对 CD 无症状，但他拒绝进行内镜确认。46 例患者中有 29 例携带 HLA-DQ2 和/或-DQ8 异二聚体。与正常对照组相比，T1DM 患者 HLA-DQB10201/02 和 HLA-DQB10302 等位基因频率显著升高（27%和 14%；P<0.001 和 P=0.002）。
与对照组相比，T1DM 患儿 HLA-DQB10201/02 和 DQB10302 等位基因频率显著升高。这表明这些等位基因在 T1DM 的发生中可能起重要作用。在泰国 T1DM 患儿中，通过血清学检测进行 CD 筛查的患病率可以忽略不计。
