Prevalence of Celiac Disease Autoimmunity Among Adolescents and Young Adults in China

Yuan, Juanli; Zhou, Chunyan; Gao, Jinyan; Li, Jingjing; Yu, Fenglian; Lü, Jun; Li, Xin; Wang, Xiaozhong; Tong, Ping; Wu, Zhihua; Yang, Anshu; Yao, Yonghong; Nadif, Sarah; Shu, H.; Xu, Jie; Wu, Yujie; Gilissen, L.J.W.J.

doi:10.1016/j.cgh.2017.04.025

Cited by 52 publications

(46 citation statements)

References 23 publications

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“…To date, data on 21‐OH and tTG autoantibodies in ADM are scarce, both in China and elsewhere. The biopsy‐positive and serum‐positive prevalence of coeliac disease tend to be low among Asians in general (0.5% and 1.6%, respectively), while autoimmunity (positive results in assays for anti‐tTG IgA and anti‐DGP‐IgG) was only 0.06% . We found, for the first time, that in Chinese people with adult‐onset diabetes the frequency of tTG autoantibody positivity was higher in those with ADM (2.1%) than in those without (0.3%).…”

Section: Discussionmentioning

confidence: 65%

“…The biopsy-positive and serum-positive prevalence of coeliac disease tend to be low among Asians in general (0.5% and 1.6%, respectively) 28 , while autoimmunity (positive results in assays for anti-tTG IgA and anti-DGP-IgG) was only 0.06%. 29 We found, for the first time, that in Chinese people with adult-onset diabetes the frequency of tTG autoantibody positivity was higher in those with ADM (2.1%) than in those without (0.3%). People with diabetes positive for GAD or IA2 autoantibodies were also at particularly high risk of tTG autoantibody positivity (OR 7.0 and OR 19.1, respectively).…”

Section: The Prevalence Of T1d In China Differs From Western Countries;mentioning

confidence: 61%

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Identification of autoimmune type 1 diabetes and multiple organ‐specific autoantibodies in adult‐onset non‐insulin‐requiring diabetes in China: A population‐based multicentre nationwide survey

Xiang

Huang

Zhu

et al. 2018

Diabetes Obesity Metabolism

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Aims: To investigate the prevalence of adult-onset autoimmune diabetes (ADM) and predisposition to autoimmune diseases by quantifying serum organ-specific autoantibodies in people with phenotype of type 2 diabetes (T2D). Materials and methods:We included a nationally representative sample of 46 239 adults aged ≥20 years from 14 provinces, of whom 4671 had diabetes, plus 1000 control subjects with normal glucose tolerance (NGT). Participants were screened centrally for autoantibodies to glutamic acid decarboxylase (GAD), islet antigen 2 (IA2) and zinc transporter isoform-8 (Znt8) and were defined as having ADM where positive for these antibodies. We then assayed thyroid peroxidase (TPO), tissue transglutaminase (tTG) and 21-hydroxylase (21-OH) autoantibodies in randomly selected participants with ADM and in age-matched, sex-matched and non-ADM controls with T2D plus controls with NGT.Results: Post-normalization, the standardized prevalence rate of ADM was 6.0% (95% confidence interval [CI] 5.3-6.8) in initially non-insulin-requiring participants with ADM, corresponding to six million adults in China, in whom adjusted antibody positivity was: TPO autoantibodies 16.3% (95% CI 10.8-21.8), tTG autoantibodies 2.1% (95% CI 0.0-4.2), and 21-OH autoantibodies 1.8% (95% CI -0.2 to 3.8). Those participants with ADM who were GAD autoantibody-positive had high risk of TPO autoantibody positivity (odds ratio[OR] 2.39, P = 0.0031) and tTG autoantibody positivity (OR 6.98, P = 0.027), while those positive for IA2 autoantibodies had a high risk of tTG autoantibody positivity (OR 19.05, P = 0.001).Conclusions: A proportion of people with phenotype of T2D in China have ADM, with diabetes-associated autoantibodies, and may be at risk of developing other organ-specific autoimmune diseases; therefore, it may be clinically relevant to consider screening such Chinese populations. K E Y W O R D Stype 1 diabetes, autoimmune diabetes, GAD-Ab, IA2-Ab, ZnT8-Ab, TPO-Ab, tTG-Ab, 21- OH-Ab

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Section: Discussionmentioning

confidence: 65%

Section: The Prevalence Of T1d In China Differs From Western Countries;mentioning

confidence: 61%

Identification of autoimmune type 1 diabetes and multiple organ‐specific autoantibodies in adult‐onset non‐insulin‐requiring diabetes in China: A population‐based multicentre nationwide survey

Xiang

Huang

Zhu

et al. 2018

Diabetes Obesity Metabolism

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“…There is only one epidemiologic study on coeliac disease in China up to now. In that study, 9 the majority of the subjects belonged to the Han group, tested for coeliac disease with coeliac disease‐specific serum markers. None of the positive subjects was further diagnosed with biopsy, which limits that study as a reliable estimation to the prevalence of coeliac disease in the Han group and other ethnic groups in China.…”

Section: Discussionmentioning

confidence: 99%

“…In Turkey (1%‐1.74%), 4,5 Syria (1.67%) 6 and Iran (0.6%‐3%) 7,8 figures comparable to those reported in Europe and the United States were found. In the Han Chinese population living in the eastern part of the Silk Road, the seroprevalence of coeliac disease has been estimated to be only 0.06% 9 . We have studied the occurrence of coeliac disease in a Silk Road region, located between east and west, where several distinct ethnic groups live.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of coeliac disease in Northwest China: heterogeneity across Northern Silk road ethnic populations

Zhou

Gao

et al. 2020

Aliment Pharmacol Ther

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Background: Epidemiological data of coeliac disease are lacking from the central Asian region. Aims: To verify the occurrence of coeliac disease amongst four major ethnic groups of Xinjiang Uyghur Autonomus Region, China. Methods: 2277 in-patients with gastrointestinal symptoms (1391 Han, 608 Uyghur, 146 Kazakh and 132 Hui; mean age: 54 ± 12.8 years) were included. Total IgA, antideamidated gliadin peptide (DGP)-IgG, and anti-tissue transglutaminase (anti-tTG)-IgA were analysed. All antibody-positive subjects were further tested for endomysial (EMA) antibodies and were HLA genotyped. All subjects with antibody positivity were asked to undergo intestinal biopsy. In addition, a subset of antibody-negative subjects were tested for HLA-DQA1and DQB1.Results: Among the 2277 subjects, 29 subjects were defined as coeliac disease autoimmune (positive results for anti-tTG IgA and EMA-IgA) (1.27%; 95% confidence interval, 0.81%-1.73%), eight of them underwent biopsy and all showed coeliac disease histology (0.35%; 95% Cl, 0.11%-0.59%). The frequency of coeliac disease autoimmunity was lowest among the Han (0.79%), followed by the Uyghur (1.81%), the Kazakh (2.05%) and the Hui (3.03%). The frequency of the HLA-DQ2 and/or DQ8 haplotype was highest in the Uyghur (52.1%), followed by the Hui (44.4%), the Kazakh (40.0%) and the Han (39.4%). Besides, a three times higher frequency of coeliac disease autoimmunity was found among rural living subjects with significantly higher wheat consumption compared to urban living subjects (3.16% vs 0.97%, P < 0.01). Conclusions:In Xinjiang, coeliac disease does occur, especially in the rural area. The HLA haplotype and environment play key roles in the development of coeliac disease. | 1117ZHOU et al.

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“…In addition, thyroglobulin antibody (TGA) is also used as a reference index for the diagnosis of AITD. Celiac disease afflicts approximately 1% of the global population, but the overall incidence is low in China (0.06%); however, the incidence in the northern provinces of Shandong, where wheat is the main staple food, reaches 0.76% [7]. Type 1 diabetes mellitus is considered a strong risk factor for CD.…”

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confidence: 99%

Organ-specific autoantibodies in Chinese patients newly diagnosed with type 1 diabetes mellitus

Pan

Shi

et al. 2020

Endocr J

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This study aims to investigate the prevalence of islet autoantibodies and other organ-specific autoantibodies in type 1 diabetes mellitus (T1DM) patients and characterize their clinical features. Glutamic acid decarboxylase antibody (GADA), insulinoma antigen 2 antibody (IA-2A), zinc transporter 8 antibody (ZnT8A) and tetraspanin7 antibody (TSPAN7A) were assayed by radioligand or luciferase immunoprecipitation system assays in 205 newly diagnosed acute-onset T1DM patients and 170 healthy controls. Other organ-specific autoantibodies, including thyroid peroxidase antibody (TPOA), thyroglobulin antibody (TGA), tissue transglutaminase antibody (tTGA) and 21-hydroxylase antibody (21-OHA), were also measured. The prevalence of GADA, IA-2A, ZnT8A, TSPAN7A, TPOA, TGA and 21-OHA was higher in T1DM patients than in healthy controls. The combinational assay of various islet autoantibodies could increase the frequency of autoantibody positivity in T1DM to 85.4%. GADA+ IA-2A+ T1DM patients preferentially had TPOA and TGA, while IA-2A+ patients often had tTGA. Patients positive for two or more islet autoantibodies often had TPOA and TGA. BMI of multiple islet autoantibodypositive patients was lower than that of patients with single or no islet autoantibodies, and there were no significant differences in C-peptide and glycated hemoglobin between patients positive for islet autoantibodies combined with other organ-specific antibodies and noncombined patients. Younger female patients who were islet autoantibody positive were more likely to have TPOA and TGA. The frequency of Graves' disease was much higher in T1DM patients than in healthy controls. T1DM usually occurs together with other organ-specific autoantibodies. Measuring of other organ-specific autoantibodies will be beneficial for T1DM patients.

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Prevalence of Celiac Disease Autoimmunity Among Adolescents and Young Adults in China

Cited by 52 publications

References 23 publications

Identification of autoimmune type 1 diabetes and multiple organ‐specific autoantibodies in adult‐onset non‐insulin‐requiring diabetes in China: A population‐based multicentre nationwide survey

Identification of autoimmune type 1 diabetes and multiple organ‐specific autoantibodies in adult‐onset non‐insulin‐requiring diabetes in China: A population‐based multicentre nationwide survey

Prevalence of coeliac disease in Northwest China: heterogeneity across Northern Silk road ethnic populations

Organ-specific autoantibodies in Chinese patients newly diagnosed with type 1 diabetes mellitus

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