PMID- 10566650
OWN - NLM
STAT- MEDLINE
DCOM- 19991126
LR  - 20221207
IS  - 0021-972X (Print)
IS  - 0021-972X (Linking)
VI  - 84
IP  - 11
DP  - 1999 Nov
TI  - High prevalence of manifestations of gastric autoimmunity in parietal cell 
      antibody-positive type 1 (insulin-dependent) diabetic patients. The Belgian 
      Diabetes Registry.
PG  - 4062-7
AB  - Previous studies have shown a high prevalence of gastric parietal cell antibodies 
      (PCA) in type 1 diabetes, which can be accompanied by (sub)clinical autoimmune 
      gastric disease. This study aimed to determine the grade of associated 
      autoimmunity and to assess the pattern of prevalence of PCA by gender, age, 
      duration of disease, age at onset of diabetes, and human leukocyte antigen (HLA) 
      type in an adult type 1 diabetic population. Furthermore, to examine the clinical 
      significance of being PCA positive, manifestations of gastric autoimmune disease 
      were studied in PCA-positive and PCA-negative patients. The population studied 
      consisted of 497 type 1 diabetics (men/women, 252/245; mean age, 40.8 +/- 12.1 
      yr; mean duration of disease, 16.4 +/- 10.4 yr; mean age at onset, 26.9 +/- 13.5 
      yr; mean hemoglobin A1c, 8.1 +/- 1.6%). Associated autoantibodies were present in 
      39% and PCA were present in 20.9% of the subjects, particularly in older 
      patients. Gender, duration, and age at onset of diabetes did not influence the 
      appearance of PCA. Antithyroid peroxidase antibodies (aTPO) were more frequent in 
      PCA-positive patients than in those without PCA (33.6% vs. 22.4%; P = 0.025), 
      suggesting an association between gastric and thyroid autoimmunity. We could 
      demonstrate an association between PCA and the HLA DR5 haplotype (P = 0.001) as 
      well, but not with HLA DR3 and/or DR4. In the PCA-positive group, iron deficiency 
      anemia was detected in 15.4%, and pernicious anemia was found in 10.5% of 
      subjects. These autoimmune gastric manifestations were significantly more 
      prevalent in PCA-positive diabetics than in PCA-negative subjects, in whom the 
      percentages were 6.9% and 0.5%, respectively (P = 0.01 and P < 0.0001). PCA were 
      prevalent in 84.6% of patients with pernicious anemia. A gastroscopic and 
      anatomopathological examination performed in a subgroup of 30 patients with 
      gastric symptoms revealed atrophic gastritis in 13 of 14 PCA-positive patients 
      and in 9 of 16 PCA-negative subjects (P = 0.04). PCA were present in 59.1% of 
      patients with atrophic gastritis. In conclusion, a high prevalence of parietal 
      cell antibodies and associated autoimmune gastric disease is present in 
      PCA-positive type 1 diabetics, recommending its screening. Early detection of PCA 
      and iron deficiency anemia, pernicious anemia, and atrophic gastritis and the 
      subsequent care could reduce the morbidity of type 1 diabetes.
FAU - De Block, C E
AU  - De Block CE
AD  - Department of Endocrinology-Diabetology, University of Antwerp, University 
      Hospital Antwerp, Edegem, Belgium. christophe.deblock@uia.ua.ac.be
FAU - De Leeuw, I H
AU  - De Leeuw IH
FAU - Van Gaal, L F
AU  - Van Gaal LF
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
RN  - 0 (Autoantibodies)
RN  - 0 (Gastrins)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (HLA-DR1 Antigen)
RN  - 0 (thyroid microsomal antibodies)
RN  - E1UOL152H7 (Iron)
SB  - IM
MH  - Adult
MH  - Aging
MH  - Anemia, Pernicious/immunology
MH  - Autoantibodies/blood
MH  - Autoimmune Diseases/blood/*immunology
MH  - Diabetes Mellitus, Type 1/blood/*immunology
MH  - Female
MH  - Gastrins/blood
MH  - Gastritis, Atrophic/immunology/pathology
MH  - Glycated Hemoglobin/analysis
MH  - HLA-DR1 Antigen/analysis
MH  - Humans
MH  - Iron/blood
MH  - Male
MH  - Middle Aged
MH  - Parietal Cells, Gastric/*immunology
MH  - Risk Factors
MH  - Sex Characteristics
EDAT- 1999/11/24 00:00
MHDA- 1999/11/24 00:01
CRDT- 1999/11/24 00:00
PHST- 1999/11/24 00:00 [pubmed]
PHST- 1999/11/24 00:01 [medline]
PHST- 1999/11/24 00:00 [entrez]
AID - 10.1210/jcem.84.11.6095 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 1999 Nov;84(11):4062-7. doi: 10.1210/jcem.84.11.6095.