Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.
Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.
J Formos Med Assoc. 2019 Jul;118(7):1114-1121. doi: 10.1016/j.jfma.2019.03.017. Epub 2019 Apr 9.
BACKGROUND/PURPOSE: Our previous study found that 177 of 1064 atrophic glossitis (AG) patients have serum gastric parietal cell antibody (GPCA) positivity only (so-called GPCAAG patients). This study assessed whether serum GPCA positivity or AG itself was a significant factor causing hematinic deficiencies and hyperhomocysteinemia in GPCAAG or GPCA-negative, thyroglobulin antibody (TGA)-negative, and thyroid microsomal antibody (TMA)-negative AG (GPCA־TGA־TMA־AG) patients.
The mean blood hemoglobin (Hb), iron, vitamin B12, folic acid, and homocysteine levels were measured and compared between any two of three groups of 177 GPCAAG patients, 476 GPCA־TGA־TMA־AG patients, and 532 healthy control subjects.
GPCAAG patients had significantly lower mean blood Hb and iron (for women only) levels and a significantly higher mean serum homocysteine level than healthy control subjects. Moreover, GPCAAG patients had significantly greater frequencies of blood Hb, iron, and vitamin B12 deficiencies and hyperhomocysteinemia than healthy control subjects. GPCAAG patients have a lower mean serum vitamin B12 level and a significantly higher mean serum homocysteine level as well as significantly greater frequencies of vitamin B12 deficiency and hyperhomocysteinemia than GPCA־TGA־TMA־AG patients. Moreover, GPCA־TGA־TMA־AG patients did have significantly lower mean blood Hb and iron levels and significantly greater frequencies of blood Hb, iron, vitamin B12, and folic acid deficiencies and hyperhomocysteinemia than healthy control subjects.
The GPCA is a major factor causing vitamin B12 deficiency and hyperhomocyteinemia in GPCAAG patients. AG itself does play a significant role in causing anemia, hematinic deficiencies, and hyperhomocysteinemia in both GPCAAG and GPCA־TGA־TMA־AG patients.
背景/目的：我们之前的研究发现，在 1064 例萎缩性舌炎（AG）患者中，有 177 例仅出现血清壁细胞抗体阳性（所谓的 GPCAAG 患者）。本研究评估了血清 GPCA 阳性或 AG 本身是否是导致 GPCAAG 或 GPCA-阴性、甲状腺球蛋白抗体（TGA）阴性和甲状腺微粒体抗体（TMA）阴性 AG（GPCA-TGA-TMA-AG）患者发生血液学缺乏和高同型半胱氨酸血症的重要因素。
测量并比较了 177 例 GPCAAG 患者、476 例 GPCA-TGA-TMA-AG 患者和 532 例健康对照组中任意两组之间的平均血血红蛋白（Hb）、铁、维生素 B12、叶酸和同型半胱氨酸水平。
GPCAAG 患者的平均血 Hb 和铁（仅女性）水平明显较低，血清同型半胱氨酸水平明显较高，与健康对照组相比。此外，GPCAAG 患者的血 Hb、铁和维生素 B12 缺乏和高同型半胱氨酸血症的发生率明显高于健康对照组。GPCAAG 患者的平均血清维生素 B12 水平较低，血清同型半胱氨酸水平较高，维生素 B12 缺乏和高同型半胱氨酸血症的发生率明显高于 GPCA-TGA-TMA-AG 患者。此外，GPCA-TGA-TMA-AG 患者的平均血 Hb 和铁水平明显较低，血 Hb、铁、维生素 B12 和叶酸缺乏以及高同型半胱氨酸血症的发生率明显高于健康对照组。
GPCA 是 GPCAAG 患者维生素 B12 缺乏和高同型半胱氨酸血症的主要因素。AG 本身确实在 GPCAAG 和 GPCA-TGA-TMA-AG 患者的贫血、血液学缺乏和高同型半胱氨酸血症中发挥重要作用。
