Health Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague, The Netherlands.
The Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands.
BMC Pediatr. 2023 Jun 7;23(1):286. doi: 10.1186/s12887-023-04041-x.
Suboptimal vitamin D status is common in people with celiac disease (CeD), a disease that can be characterized by the presence of serum anti-tissue transglutaminase antibodies (TG2A) (i.e., TG2A positivity). To date, it remains unclear whether childhood TG2A positivity is associated with vitamin D status and how this potential association can be explained by other factors than malabsorption only, since vitamin D is mainly derived from exposure to sunlight. The aim of our study was therefore to assess whether childhood TG2A positivity is associated with vitamin D concentrations, and if so, to what extent this association can be explained by sociodemographic and lifestyle factors.
This cross-sectional study was embedded in the Generation R Study, a population-based prospective cohort. We measured serum anti-tissue transglutaminase antibodies (TG2A) concentrations and serum 25-hydroxyvitamin D (25(OH)D) concentrations of 3994 children (median age of 5.9 years). Children with serum TG2A concentrations ≥ 7 U/mL were considered TG2A positive. To examine associations between TG2A positivity and 25(OH)D concentrations, we performed multivariable linear regression, adjusted for sociodemographic and lifestyle factors.
Vitamin D deficiency (serum 25(OH)D < 50 nmol/L) was found in 17 out of 54 TG2A positive children (31.5%), as compared to 1182 out of 3940 TG2A negative children (30.0%). Furthermore, TG2A positivity was not associated with 25(OH)D concentrations (β -2.20; 95% CI -9.72;5.33 for TG2A positive vs. TG2A negative children), and this did not change after adjustment for confounders (β -1.73, 95% CI -8.31;4.85).
Our findings suggest there is no association between TG2A positivity and suboptimal vitamin D status in the general pediatric population. However, the overall prevalence of vitamin D deficiency in both populations was high, suggesting that screening for vitamin D deficiency among children, regardless of TG2A positivity, would be beneficial to ensure early dietary intervention if needed.
乳糜泻（CeD）患者普遍存在维生素 D 状态不佳的情况，这种疾病的特征可以表现为血清抗组织转谷氨酰胺酶抗体（TG2A）阳性（即 TG2A 阳性）。迄今为止，尚不清楚儿童期 TG2A 阳性是否与维生素 D 状态有关，以及这种潜在的关联除了吸收不良之外，还可以通过哪些因素来解释，因为维生素 D 主要来源于暴露在阳光下。因此，我们的研究目的是评估儿童期 TG2A 阳性是否与维生素 D 浓度有关，如果是这样，这种关联在多大程度上可以通过社会人口统计学和生活方式因素来解释。
这项横断面研究是在出生队列研究 Generation R 中进行的。我们测量了 3994 名儿童（中位年龄为 5.9 岁）的血清抗组织转谷氨酰胺酶抗体（TG2A）浓度和血清 25-羟维生素 D（25（OH）D）浓度。血清 TG2A 浓度≥7 U/mL 的儿童被认为是 TG2A 阳性。为了研究 TG2A 阳性与 25（OH）D 浓度之间的关系，我们进行了多变量线性回归，调整了社会人口统计学和生活方式因素。
在 54 名 TG2A 阳性儿童中，有 17 名（31.5%）存在维生素 D 缺乏（血清 25（OH）D<50 nmol/L），而在 3940 名 TG2A 阴性儿童中，有 1182 名（30.0%）存在维生素 D 缺乏。此外，TG2A 阳性与 25（OH）D 浓度无关（β-2.20；95%置信区间-9.72；5.33，与 TG2A 阳性儿童相比，TG2A 阴性儿童），且在调整混杂因素后仍无相关性（β-1.73，95%置信区间-8.31；4.85）。
我们的研究结果表明，在一般儿科人群中，TG2A 阳性与维生素 D 状态不佳之间没有关联。然而，两个人群中维生素 D 缺乏的总体患病率都很高，这表明无论 TG2A 阳性与否，对儿童进行维生素 D 缺乏筛查都将是有益的，以便在需要时及早进行饮食干预。
