Bhat Khurshid A, Verma Sonali, Bhatia Eesh, Bhatia Vijayalakshmi, Sudhanshu Siddhnath
Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Indian J Endocrinol Metab. 2024 Sep-Oct;28(5):536-541. doi: 10.4103/ijem.ijem_176_24. Epub 2024 Nov 8.
Parietal cell antibody (PCA)-mediated auto-immune gastritis is known to increase the risk of iron-deficiency and pernicious anaemia in adults with type 1 diabetes mellitus. However, in children and young adults with type 1 diabetes, these data are scarce. We aimed to study the prevalence of parietal cell antibodies (PCAs) and its clinical associations in people with type 1 diabetes with onset below 30 years.
In a cross-sectional study, 224 children and young adults with type 1 diabetes and 171 healthy controls were enrolled. We measured haemoglobin, serum ferritin, vitamin B12, PCA, thyroid peroxidase, and anti-tissue transglutaminase antibodies in all patients. Mann-Whitney U test for continuous data and Chi square test for categorical data were used. Linear regression analysis was performed with haemoglobin as a dependent variable.
The prevalence of PCA was significantly higher in patients than in controls (22% vs 10.2%; = 0.002). Patients with PCA had a higher frequency of anaemia (60% vs 30%, < 0.001), lower haemoglobin [7.3 (1.6) vs 7.8 (1.1) mmol/L; = 0.002], and lower serum ferritin [46.9 (70.8) pmol/L vs 66.0 (105.3) pmol/L; = 0.04], as compared to those without PCA. On multivariate analysis, haemoglobin was associated with PCA (β = -0.174, = 0.005) and serum ferritin (β =0.247, < 0.001).
Presence of PCA was an independent risk factor for iron deficiency and anaemia in children and young adults with type 1 diabetes.
已知壁细胞抗体（PCA）介导的自身免疫性胃炎会增加1型糖尿病成年患者缺铁和患恶性贫血的风险。然而，在1型糖尿病儿童和青年中，这些数据很少。我们旨在研究1型糖尿病发病年龄在30岁以下人群中壁细胞抗体（PCA）的患病率及其临床关联。
在一项横断面研究中，纳入了224例1型糖尿病儿童和青年以及171例健康对照。我们测量了所有患者的血红蛋白、血清铁蛋白、维生素B12、PCA、甲状腺过氧化物酶和抗组织转谷氨酰胺酶抗体。对连续数据采用曼-惠特尼U检验，对分类数据采用卡方检验。以血红蛋白为因变量进行线性回归分析。
患者中PCA的患病率显著高于对照组（22%对10.2%；P = 0.002）。与无PCA的患者相比，有PCA的患者贫血发生率更高（60%对30%，P < 0.001），血红蛋白更低[7.3（1.6）对7.8（1.1）mmol/L；P = 0.002]，血清铁蛋白更低[46.9（70.8）pmol/L对66.0（105.3）pmol/L；P = 0.04]。多变量分析显示，血红蛋白与PCA（β = -0.174，P = 0.005）和血清铁蛋白（β = 0.247，P < 0.001）相关。
PCA的存在是1型糖尿病儿童和青年缺铁和贫血的独立危险因素。
