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中国西北青年人群乳糜泻自身免疫的临床特征筛查与分析

Screening and Analysis of the Clinical Characteristics of Celiac Disease Autoimmunity in the Young Population in Northwest China.

作者信息

Shi Tian, Xue Sheng Long, Liu Wei Dong, Feng Yan, Li Ting, Li Na, Aihemaijiang Kuerbanjiang, Huang Xiao Ling, Hui Wen Jia, Jiang Qi, Chen Ying Xuan, Gao Feng

机构信息

Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, NHC Key Laboratory of Digestive Diseases, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Department of Gastroenterology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang Uygur Autonomous Region, China.

出版信息

J Dig Dis. 2025 Mar-Apr;26(3-4):143-149. doi: 10.1111/1751-2980.13351. Epub 2025 Jun 12.

Abstract

OBJECTIVE

We aimed to evaluate the prevalence of celiac disease (CeD) autoimmunity among young adult individuals in northwest China based on their relevant demographics, clinical characteristics, and laboratory data.

METHODS

We conducted a cross-sectional survey of serum CeD prevalence among young students aged 18-23 years who underwent routine physical examinations at the Xinjiang Second Medical College from September 2022 to December 2023. All subjects were tested for total serum immunoglobulin (Ig) A levels. Those with normal total IgA levels were tested for anti-tissue transglutaminase (tTG)-IgA and anti-endomysial antibody (EMA)-IgA. Individuals with IgA deficiency were tested for anti-deamidated gliadin peptide (DGP) IgG and anti-EMA-IgG. CeD autoimmunity was defined as positivity for both EMA and tTG/DGP antibodies.

RESULTS

Among the 1464 participants, CeD seropositivity rates were 0.41% for tTG-IgA and 0.55% for EMA-IgA, and CeD autoimmunity was prevalent in 0.34%. All seropositive patients had a normal body mass index. The incidence of seropositivity was highest in Tajiks (1.28%), followed by Kazakhs (0.97%), Hans (0.29%), and Uygurs (0.22%) (p > 0.05). CeD was most frequently associated with elevated transaminase levels (1.87%; p = 0.005). Biochemical tests showed significantly higher alanine aminotransferase levels in CeD-positive patients (p = 0.027).

CONCLUSIONS

The prevalence of CeD autoimmunity in the young adult population of northwest China was 0.34%. Since young individuals often lack typical clinical and laboratory features, screening for CeD in the population with gastrointestinal symptoms, related comorbidities, or atypical manifestations is essential for early diagnosis and effective management of the disease.

摘要

目的

基于相关人口统计学、临床特征和实验室数据,评估中国西北青年成人乳糜泻(CeD)自身免疫的患病率。

方法

我们对2022年9月至2023年12月在新疆第二医学院接受常规体检的18 - 23岁青年学生进行了血清CeD患病率的横断面调查。所有受试者均检测血清总免疫球蛋白(Ig)A水平。总IgA水平正常者检测抗组织转谷氨酰胺酶(tTG)-IgA和抗肌内膜抗体(EMA)-IgA。IgA缺乏者检测抗脱酰胺麦醇溶蛋白肽(DGP)IgG和抗EMA-IgG。CeD自身免疫定义为EMA和tTG/DGP抗体均为阳性。

结果

在1464名参与者中,tTG-IgA的CeD血清阳性率为0.41%,EMA-IgA为0.55%,CeD自身免疫患病率为0.34%。所有血清阳性患者的体重指数均正常。血清阳性发生率在塔吉克族中最高(1.28%),其次是哈萨克族(0.97%)、汉族(0.29%)和维吾尔族(0.22%)(p>0.05)。CeD最常与转氨酶水平升高相关(1.87%;p = 0.005)。生化检测显示CeD阳性患者的丙氨酸转氨酶水平显著更高(p = 0.027)。

结论

中国西北青年成人中CeD自身免疫的患病率为0.34%。由于年轻人往往缺乏典型的临床和实验室特征,因此对有胃肠道症状、相关合并症或非典型表现的人群进行CeD筛查对于该疾病的早期诊断和有效管理至关重要。

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