中国南方乳糜泻易患人群的相关抗体测定及临床特征分析  

Serological screening and analysis of clinical characteristics for celiac disease in susceptible population in Southern China

作　　者：刘秀莹 周琬琰 吴为[2] 何美蓉[1] 郑德开 纪桂元[2] 马文军[2] 陈烨[1] Liu Xiuying;Zhou Wanyan;Wu Wei;He Meirong;Zheng Dekai;Ji Guiyuan;Ma Wenjun;Chen Ye(Department of Gastroenterology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Guangdong Provincial Institute of Public Health,Guangdong Provincial Center for Disease Control and Prevention,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院消化内科,广州510515 [2]广东省疾病预防控制中心广东省公共卫生研究院,广州510515

出　　处：《中华内科杂志》2021年第6期539-543,共5页Chinese Journal of Internal Medicine

基　　金：国家重点研发计划项目(2018YFC1314100);广东省自然科学基金(2018A0303130118)。

摘　　要：目的通过对易患乳糜泻人群血清中抗组织转谷氨酰胺酶IgA抗体(TTGA)、抗脱酰氨基麦胶蛋白IgA、IgG抗体(DGPA、DGPG)的测定,进一步分析人口学特征、生活饮食习惯与血清学阳性者之间的关系,从而指导我国南方乳糜泻的防治工作。方法选取2015年广东省成人慢性病与营养监测疾病项目中的易患乳糜泻人群(肠易激综合征、结肠炎、腹泻、贫血、低体重指数、身材矮小、1型糖尿病、类风湿关节炎、强直性脊柱炎、牛皮癣,布利斯托粪便为第6或第7型)1273例为本横断面研究的研究对象,采用化学发光法检测血清中乳糜泻特异性抗体TTGA、DGPA、DGPG水平,比较不同高危人群乳糜泻血清抗体阳性率情况,另外收集研究对象的人口学特征、生活饮食习惯等一般临床资料,评价以上因素与血清学抗体阳性的相关性。结果中国南方高危人群乳糜泻血清阳性率为0.94%(95%CI 0.54%~1.64%),其中TTGA阳性率为0.08%(1/1273),DGPA阳性率为0.47%(6/1273),DGPG阳性率为0.39%(5/1273)。各组高危人群血清学阳性率分别为牛皮癣组3.6%(1/28),低体重指数组2.1%(2/95),1型糖尿病组1.9%(1/53),腹泻症状组1.8%(3/169),类风湿关节炎组1.1%(5/463)。研究发现血清抗体阳性组和抗体阴性组在年龄、性别、有无吸烟及饮酒不良嗜好、饮食方面差异均无统计学意义(P值均>0.05)。结论在中国南方,乳糜泻血清学阳性率在高危人群为0.94%。因此,推荐在高危人群中进行乳糜泻血清学筛查,可以为乳糜泻的早期诊断提供重要参考依据。Objective To determine the seroprevalence of celiac disease in susceptible population,and to analyze the relationship between demographic characteristics,dietary habits,lifestyle and serological positivity so as to provide guidance for the prevention and treatment of celiac disease in Southern China.Methods A total of 1273 individuals who participated in Guangdong Province Health Screening Program in 2015,were selected as serologically positive subjects of celiac disease,including people with irritable bowel syndrome,colitis,diarrhea,anemia,low BMI,short stature,type 1 diabetes mellitus(T1DM),rheumatoid arthritis(RA),ankylosing spondylitis,psoriasis and bristol grade=6 or 7.All subjects were tested for serum IgA anti-tissue transglutaminase antibodies(TTGA),IgA antibodies against deamidated gliadin peptides(DGPA)and IgG against deamidated gliadin peptides(DGPG).Dietary habits,lifestyle and demographic characteristics were compared in subgroups.Results The seroprevalence of celiac disease in susceptible population was 0.94%(95%CI 0.54%-1.64%)including 0.08%(1/1273)for TTGA,0.47%(6/1273)for DGPA,and 0.39%(5/1273)for DGPG.The seropositive rate was 3.6%(1/28)in patients with psoriasis,2.1%(2/95)in the low BMI group,1.9%(1/53)in T1DM group,1.8%(3/169)in diarrhea group and 1.1%(5/463)in RA group.No significant difference was found in age,gender,high carbohydrate diet or lifestyle between the negative and the positive subjects.Conclusions In Southern China,the seropositive rate of celiac disease is 0.94%in susceptible population,which prompts an urgent need of serological screening for early diagnosis.

关 键 词：乳糜泻 抗体 流行病学 诊断 

分 类 号：R597.8[医药卫生—内科学]