1 型糖尿病患者潜伏和显性多自身免疫的患病率:系统回顾与荟萃分析。

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM
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引用次数: 0

摘要

背景:1 型糖尿病(T1D)患者表现出多自身免疫(PolyA)。然而,PolyA 在 T1D 患者中的发生率和分布情况尚不清楚:我们进行了一项系统综述和荟萃分析,以确定 T1D 患者中潜伏和显性 PolyA 的患病率:按照 PRISMA 指南,我们在医学数据库中进行了全面检索,确定了有关 T1D 患者潜伏和显性 PolyA 的研究。两名研究人员独立筛选、提取数据并评估研究质量。采用随机效应模型计算潜伏PolyA和显性PolyA的总患病率及其相应的95%置信区间(CI)。通过元回归分析研究了研究设计、年龄、性别和病程对集合患病率的影响:共对 158 篇文章进行了仔细研究,这些文章涵盖了不同的研究设计。分析包括 270,890 名确诊为 T1D 的患者。性别分布均匀(50.30% 为男性)。值得注意的是,我们的分析揭示了公开的 PolyA 患病率为 8.50%(95 % CI,6.77 至 10.62),其中北美的患病率最高(14.50%,95 % CI,7.58 至 24.89)。这种 PolyA 特征的另一个特点是并发自身免疫性甲状腺疾病的发病率很高(7.44%,95 % CI,5.65 至 9.74)。此外,我们还发现在 T1D 群体中潜伏 PolyA 的发病率很高,为 14.45 %(95 % CI,11.17 至 18.49),其中亚洲(23.29 %,95 % CI,16.29 至 32.15)和大洋洲(21.53 %,95 % CI,16.48 至 27.62)的发病率最高。值得注意的是,这种潜伏的 PolyA 现象主要表现为一系列自身抗体,包括类风湿因子,其次是 Ro52、甲状腺过氧化物酶抗体和甲状腺球蛋白抗体。病程与潜伏(β:0.0456,P 值:0.0140)和显性 PolyA(β:0.0373,P 值:0.0152)的最高频率相关。研究设计不同,汇总的患病率也不同:这项荟萃分析在早期检测 T1D 患者的 PolyA 方面取得了重大进展。T1D患者应定期接受评估,以识别潜在的并发自身免疫性疾病,尤其是随着年龄的增长。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prevalence of latent and overt polyautoimmunity in type 1 diabetes: A systematic review and meta-analysis

Background

Patients afflicted by type 1 diabetes (T1D) exhibit polyautoimmunity (PolyA). However, the frequency and distribution of PolyA in T1D is still unknown.

Objective

We conducted a systematic review and meta-analysis to define the prevalence of latent and overt PolyA in individuals with T1D.

Methods

Following PRISMA guidelines, a comprehensive search across medical databases identified studies on latent and overt PolyA in T1D. Two researchers independently screened, extracted data, and assessed study quality. A random effects model was utilized to calculate the pooled prevalence, along with its corresponding 95 % confidence interval (CI), for latent PolyA and overt PolyA. Meta-regression analysis was conducted to study the effect of study designs, age, sex, and duration of disease on pooled prevalence.

Results

A total of 158 articles, encompassing a diverse composition of study designs were scrutinized. The analysis included 270,890 individuals with a confirmed diagnosis of T1D. The gender was evenly distributed (50.30 % male). Notably, our analysis unveiled an overt PolyA prevalence rate of 8.50 % (95 % CI, 6.77 to 10.62), with North America having the highest rates (14.50 %, 95 % CI, 7.58 to 24.89). This PolyA profile was further characterized by a substantial incidence of concurrent autoimmune thyroid disease (7.44 %, 95 % CI, 5.65 to 9.74). Moreover, we identified a notable prevalence of latent PolyA in the T1D population, quantified at 14.45 % (95 % CI, 11.17 to 18.49) being most frequent in Asia (23.29 %, 95 % CI, 16.29 to 32.15) and Oceania (21.53 %, 95 % CI, 16.48 to 27.62). Remarkably, this latent PolyA phenomenon primarily featured an array of autoantibodies, including rheumatoid factor, followed by Ro52, thyroid peroxidase antibodies, and thyroglobulin antibodies. Duration of the disease was associated with a highest frequency of latent (β: 0.0456, P-value: 0.0140) and overt PolyA (β: 0.0373, P-value: 0.0152). No difference in the pooled prevalence by study design was observed.

Conclusion

This meta-analysis constitutes a substantial advancement in the realm of early detection of PolyA in the context of T1D. Individuals with T1D should regularly undergo assessments to identify potential concurrent autoimmune diseases, especially as they age.

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来源期刊
CiteScore
22.90
自引率
2.00%
发文量
248
审稿时长
51 days
期刊介绍: Diabetes and Metabolic Syndrome: Clinical Research and Reviews is the official journal of DiabetesIndia. It aims to provide a global platform for healthcare professionals, diabetes educators, and other stakeholders to submit their research on diabetes care. Types of Publications: Diabetes and Metabolic Syndrome: Clinical Research and Reviews publishes peer-reviewed original articles, reviews, short communications, case reports, letters to the Editor, and expert comments. Reviews and mini-reviews are particularly welcomed for areas within endocrinology undergoing rapid changes.
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