Department of Nephrology and Rheumatology, Kanazawa University Hospital, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan.
Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Arthritis Res Ther. 2024 Sep 6;26(1):156. doi: 10.1186/s13075-024-03391-w.
Elevated serum immunoglobulin G4 (IgG4) concentrations are one of the characteristic findings in IgG4-related disease (IgG4-RD). This study investigated the frequency of elevated serum IgG4 levels and associated factors in a general Japanese population.
Serum IgG4 concentrations were measured in 1,201 residents of Ishikawa prefecture who underwent general medical examinations. Factors associated with elevated serum IgG4 concentrations were assessed by logistic regression analysis. Participants with elevated serum IgG4 were subjected to secondary examinations.
The mean serum IgG4 concentration was 44 mg/dL, with 42 (3.5%) participants having elevated serum IgG4 levels. Age- and sex-adjusted logistic regression analyses showed that male sex, older age, and lower intake of lipids and polyunsaturated fatty acids and higher intake of carbohydrates in daily diet were associated with elevated serum IgG4 concentration. Subgroup analyses in men showed that older age, lower estimated glomerular filtration rates based on serum cystatin C (eGFR-cysC) levels, and higher hemoglobin A1c (HbA1c) levels were associated with elevated serum IgG4 concentration. Analyses in women showed that lower intake of lipids and fatty acids and higher intake of carbohydrates were significantly associated with elevated serum IgG4 concentration. One of the 15 participants who underwent secondary examinations was diagnosed with possible IgG4-related retroperitoneal fibrosis.
Elevated serum IgG4 levels in a Japanese general population were significantly associated with older age, male gender, and dietary intake of nutrients, with some of these factors identical to the epidemiological features of IgG4-RD.
血清免疫球蛋白 G4（IgG4）浓度升高是 IgG4 相关疾病（IgG4-RD）的特征之一。本研究调查了普通日本人群中血清 IgG4 水平升高的频率及其相关因素。
对接受一般体检的石川县 1201 名居民进行血清 IgG4 浓度检测。采用 logistic 回归分析评估与血清 IgG4 浓度升高相关的因素。对血清 IgG4 升高的患者进行二次检查。
血清 IgG4 浓度的平均值为 44mg/dL，有 42（3.5%）名患者血清 IgG4 水平升高。年龄和性别调整的 logistic 回归分析显示，男性、年龄较大、日常饮食中脂质和多不饱和脂肪酸摄入量较低、碳水化合物摄入量较高与血清 IgG4 浓度升高相关。男性亚组分析显示，年龄较大、基于血清胱抑素 C（eGFR-cysC）的估计肾小球滤过率（eGFR-cysC）较低、血红蛋白 A1c（HbA1c）水平较高与血清 IgG4 浓度升高相关。女性分析显示，脂质和脂肪酸摄入量较低、碳水化合物摄入量较高与血清 IgG4 浓度升高显著相关。在接受二次检查的 15 名患者中，有 1 名被诊断为可能的 IgG4 相关腹膜后纤维化。
日本普通人群中血清 IgG4 水平升高与年龄较大、男性和营养素的饮食摄入显著相关，其中一些因素与 IgG4-RD 的流行病学特征相同。
