委内瑞拉新近确诊的胰岛素依赖型糖尿病儿童的流行病学和免疫遗传学

P Gunczler, R Lanes, Z Layrisse, B Esparza, R Salas, L Hernández, A Arnaiz-Villena
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摘要

在委内瑞拉,以前没有对1型糖尿病儿童的遗传和免疫标志物进行过研究。我们评估了91名新诊断的IDDM儿童,平均年龄7.8 +/- 4.5(0.8-20.8岁),51名女性和40名男性。11%的一级亲属有I型IDDM家族史;56.7%的人在诊断前曾有上呼吸道感染,12.7%的人曾有腮腺炎或水痘。发病高峰在2、3月和8、10月。87%的人有HLA-DR3和/或DR4,而委内瑞拉总人口的这一比例为36%;81.6%为HLA-DQW2和/或HLA-DQW8。我们发现55.9%的患者胰岛细胞抗体(ICA)阳性,其中4例补体固定试验阳性。胰岛素自身抗体阳性3例(7.9%)。11名hla相同的兄弟姐妹中只有3人的ICAs呈阳性,而没有人的胰岛素自身抗体呈阳性。其中1例补体固定试验阳性;本课题发展IDDM。本组病例未发现柯萨奇- b型肠道病毒血清型阳性,但有11例巨细胞病毒抗体滴度升高,部分患儿麻疹、腮腺炎、疱疹和水痘抗体阳性。这些数据证实,我们的大多数I型糖尿病患者携带HLA-DR3或DR4,并且杂合DR3/DR4表型在该人群中显着增加;他们还表明,DR3QW2和DR4QW8与我们人群中风险增加有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Epidemiology and inmunogenetics in recently diagnosed Venezuelan children with insulin-dependent diabetes mellitus.

Genetic and immunological markers in children with Type I diabetes have not been studied previously in Venezuela. We evaluated 91 newly diagnosed IDDM children mean age 7.8 +/- 4.5 (range 0.8-20.8 years), 51 females and 40 males. Eleven percent of first degree relatives had a family history of Type I IDDM; 56.7% had had upper respiratory infection prior to diagnosis and 12.7% had had either mumps or varicella. Peak incidence of disease was found in February and March and August to October. Eighty seven percent had HLA-DR3 and/or DR4 vs 36% of the Venezuelan general population; 81.6% were HLA-DQW2 and/or HLA-DQW8. We found 55.9% to have positive islet cell antibodies (ICA) with 4 of these having a positive complement fixation test. Three patients (7.9%) were found to have positive insulin autoantibodies. Only 3 out of 11 HLA-identical siblings had positive ICAs, while none had positive insulin autoantibodies. One of them also had a positive complement fixation test; this subject developed IDDM. No positive serotypes for enterovirus (Coxsackie-B) were found in our patients, but we detected 11 cases with elevated titers for cytomegalovirus antibodies and positive antibodies for measles, mumps, herpes and varicella were found in some children. These data confirm that most of our Type I diabetics carry HLA-DR3 or DR4 and that the heterozygous DR3/DR4 phenotype is markedly increased in this population; they also indicate that DR3QW2 and DR4QW8 are associated with increased risk in our population.

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