摩洛哥人群中1型糖尿病患者腹腔疾病特异性自身抗体的患病率
The Prevalence of Celiac Disease-Specific Auto-Antibodies in Type 1 Diabetes in a Moroccan Population.
作者信息
Oujamaa Ider, Sebbani Majda, Elmoumou Lahcen, Bourrahouate Aïcha, El Qadiry Rabiy, El Moussaoui Soufian, Ait Sab Imane, Sbihi Mohamed, Ennazk Laila, El Mghari-Tabib Ghizlane, El Ansari Nawal, Baizri Hicham, Amine Mohamed, Admou Brahim
机构信息
Laboratory of Immunology, University Hospital of Marrakech, Marrakech, Morocco.
Department of Public Health and Epidemiology, PCIM Research Laboratory, Cadi Ayyad University, Marrakech, Morocco.
出版信息
Int J Endocrinol. 2019 Sep 19;2019:7895207. doi: 10.1155/2019/7895207. eCollection 2019.
OBJECTIVE
We aimed to determine the prevalence of specific auto-antibodies to celiac disease (CD) in Moroccan type 1 diabetic (T1D) patients and compare the clinical and biological characteristics of seropositive and seronegative cases.
PATIENTS AND METHODS
A cross-sectional study was carried out on 276 T1D patients including 109 adults and 167 pediatric cases. The screening for CD was performed by an Elisa IgA anti-tissue transglutaminase antibody (tTGA) testing, combined with IgA quantification by nephelometry. Positive-IgA-tTGA cases were secondly tested for anti-endomysial antibodies (EMA) using an immunofluorescence technique, and the IgA deficiency cases were screened for IgG-tTGA. Patients with low positive tTGA titers underwent HLA-DQ2/DQ8 typing. Sociodemographic and clinical data of the patients were collected using a hetero-administered questionnaire. The comparison of clinical and biological data between seropositive and seronegative diabetics was done using independent , Mann-Whitney , chi-squared, and Fisher tests, which were considered significant if value <0.05.
RESULTS
The prevalence of CD-specific auto-antibodies was estimated to be 9.1% (IC = 95%), with 25 positive cases in tTGA and EMA testing. Eight cases displayed low titers of IgA-tTGA, among which 4 were positive for HLA-DQ2, 1 for HLA-DQ8, and 1 for both DQ2 and DQ8. The other 2 cases had a biopsy-proven CD. Compared to seronegative patients, seropositive cases had a higher percentage of associated autoimmune disorders (16% vs. 2.4%, =0.008), with a significant lower height Z-scores (median: -0.90 (-3.93 to 0.95) vs. -0.51 (-4.54 to 2.18), =0.029) and a higher HbA1c level (median: 11.30% (7.31 to 16.00) vs. 9.30% (4.40 to17.31), =0.022).
CONCLUSION
The current study gave evidence of a high prevalence of CD specific auto-antibodies in T1D population. The co-existence of these two conditions was associated with a poor glycemic control, a lower height, and other autoimmune diseases. These findings may suggest the necessity of a systematic screening of CD in T1D patients.
目的
我们旨在确定摩洛哥1型糖尿病（T1D）患者中乳糜泻（CD）特异性自身抗体的患病率，并比较血清阳性和血清阴性病例的临床和生物学特征。
患者与方法
对276例T1D患者进行了一项横断面研究，其中包括109例成人和167例儿科病例。通过酶联免疫吸附测定法（ELISA）检测抗组织转谷氨酰胺酶抗体（tTGA）进行CD筛查，并结合散射比浊法进行IgA定量。其次，使用免疫荧光技术对IgA-tTGA阳性病例检测抗肌内膜抗体（EMA），对IgA缺乏病例筛查IgG-tTGA。tTGA滴度低阳性的患者进行HLA-DQ2/DQ8分型。使用一份他人管理的问卷收集患者的社会人口统计学和临床数据。血清阳性和血清阴性糖尿病患者之间的临床和生物学数据比较采用独立样本t检验、曼-惠特尼检验、卡方检验和费舍尔检验，如果P值<0.05，则认为具有统计学意义。
结果
CD特异性自身抗体的患病率估计为9.1%（95%置信区间），tTGA和EMA检测中有25例阳性病例。8例显示IgA-tTGA滴度低，其中4例HLA-DQ2阳性，1例HLA-DQ8阳性，1例DQ2和DQ8均阳性。另外2例经活检证实为CD。与血清阴性患者相比，血清阳性病例合并自身免疫性疾病的百分比更高（16%对2.4%，P=0.008），身高Z评分显著更低（中位数：-0.90（-3.93至0.95）对-0.51（-4.54至2.18），P=0.029），糖化血红蛋白（HbA1c）水平更高（中位数：11.30%（7.31至16.00）对9.30%（4.40至17.31），P=0.022）。
结论
本研究证明T1D人群中CD特异性自身抗体的患病率较高。这两种疾病的共存与血糖控制不佳、身高较低和其他自身免疫性疾病有关。这些发现可能表明有必要对T1D患者进行系统性CD筛查。
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