Zhang Yun, Yan Ni, Li Ya, Ma Wei-Mei, Liu Hong-Li, Yu Jing-Ni, Ma Le
Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an 710004, Shaanxi Province, China.
School of Public Health, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
Int J Ophthalmol. 2020 Nov 18;13(11):1733-1738. doi: 10.18240/ijo.2020.11.08. eCollection 2020.
To evaluate the predictive value of islet autoantibodies for the diagnosis of autoimmune uveitis (AU), as well as to characterize the association bet ween islet autoantibodies and AU.
Totally 97 patients with AU and 100 healthy persons without any autoimmune diseases as the control group were recruited. Multiple serum islet autoantibodies were measured using commercial enzyme-linked immunosorbent assay kits (ELISA). A supplementary questionnaire was used to complement the subject's demographics and clinical features. The level of glucose concentrations and white blood cells were measured. Conditional logistic regression was performed to estimate odds ratios (ORs), and 95% confidence intervals (CIs) of AU according to islet autoantibodies and to evaluate the predictive value of islet autoantibodies for AU diagnosis. Autoantibodies subgroups and other variables were included into analysis.
In AU patients, the prevalence of detecting at least one of the autoantibodies was 31.9% (31/97). The most frequent autoantibody was ZnT8A (30.9%), followed by GADA (11.3%), IA-2A (4.1%), ICA (2.1%) and IAA (2.1%). Islet autoantibodies were found to be correlated positively with AU diagnosis [OR (95%CI): 13.86 (3.28, 58.50), <0.001]. Moreover, Zn-T8A was remarkably correlated with AU diagnosis [OR (95%CI): 6.13 (1.96, 19.17), <0.001], In contrast, neither GADA nor other islet antibodies (IA-2A, ICA and IAA) showed any association with AU risk under an additive model.
The prevalence of islet antibodies, especially ZnT8A, in patients with AU is higher. Islet antibodies as well as novel biomarkers should be included in routine evaluation at AU and is a valuable biological marker to classify newly-diagnosed uveitis.
评估胰岛自身抗体对自身免疫性葡萄膜炎(AU)诊断的预测价值,并描述胰岛自身抗体与AU之间的关联。
招募了97例AU患者和100名无任何自身免疫性疾病的健康人作为对照组。使用商用酶联免疫吸附测定试剂盒(ELISA)检测多种血清胰岛自身抗体。使用补充问卷补充受试者的人口统计学和临床特征。测量血糖浓度和白细胞水平。进行条件逻辑回归以估计根据胰岛自身抗体的AU比值比(OR)和95%置信区间(CI),并评估胰岛自身抗体对AU诊断的预测价值。将自身抗体亚组和其他变量纳入分析。
在AU患者中,检测到至少一种自身抗体的患病率为31.9%(31/97)。最常见的自身抗体是锌转运体8自身抗体(ZnT8A,30.9%),其次是谷氨酸脱羧酶自身抗体(GADA,11.3%)、胰岛抗原2自身抗体(IA-2A,4.1%)、胰岛细胞自身抗体(ICA,2.1%)和胰岛素自身抗体(IAA,2.1%)。发现胰岛自身抗体与AU诊断呈正相关[OR(95%CI):13.86(3.28,58.50),<0.001]。此外,锌转运体8自身抗体(Zn-T8A)与AU诊断显著相关[OR(95%CI):6.13(1.96,19.17),<0.001]。相比之下,在相加模型下,GADA和其他胰岛抗体(IA-2A、ICA和IAA)均未显示与AU风险有任何关联。
AU患者中胰岛抗体,尤其是ZnT8A的患病率较高。胰岛抗体以及新的生物标志物应纳入AU的常规评估中,并且是对新诊断葡萄膜炎进行分类的有价值的生物标志物。