Mariani P, Mazzilli M C, Margutti G, Lionetti P, Triglione P, Petronzelli F, Ferrante E, Bonamico M
I Clinica Pediatrica, Università La Sapienza, Roma, Italia.
Acta Paediatr. 1994 Dec;83(12):1272-5. doi: 10.1111/j.1651-2227.1994.tb13014.x.
The presence of dental enamel defects in coeliac disease and their relation to hypocalcaemia or a particular HLA class in 82 Italian children with coeliac disease was studied. Demarcated opacities or hypoplasia were detected in 23 subjects (group 1) while minimal or no dental lesions were found in the remaining 59 patients (group 2); in 189 normal controls, enamel lesions were significantly less frequent than in patients with coeliac disease (14.8% versus 28.0%; p < 0.005). No statistically significant differences were found for age at diagnosis and calcium concentrations between groups 1 and 2. Regression analysis showed a correlation between age at diagnosis and number of teeth with enamel defects. In our patients, the presence of HLA DR3 antigen significantly increased the risk of dental lesions, while genotype DR5,7 seemed to protect against enamel defects. A logistic regression analysis of the variables age, serum calcium concentrations, number of affected teeth, type of enamel defect and DR antigens showed that only DR antigens discriminated coeliac disease patients with from those without enamel defects.
对82名患有乳糜泻的意大利儿童的牙釉质缺陷情况及其与低钙血症或特定人类白细胞抗原（HLA）类型的关系进行了研究。在23名受试者（第1组）中检测到有界限分明的牙釉质混浊或发育不全，而在其余59名患者（第2组）中发现极少或没有牙齿病变；在189名正常对照者中，牙釉质病变的发生率明显低于乳糜泻患者（14.8%对28.0%；p<0.005）。第1组和第2组在诊断年龄和钙浓度方面未发现统计学上的显著差异。回归分析显示诊断年龄与有牙釉质缺陷的牙齿数量之间存在相关性。在我们的患者中，HLA DR3抗原的存在显著增加了牙齿病变的风险，而DR5,7基因型似乎对牙釉质缺陷有保护作用。对年龄、血清钙浓度、患牙数量、牙釉质缺陷类型和DR抗原等变量进行的逻辑回归分析表明，只有DR抗原能够区分有牙釉质缺陷和无牙釉质缺陷的乳糜泻患者。
