RESUMEN
Individuals with type 1 diabetes (T1D) are at increased risk of coeliac disease (CD), autoimmune thyroiditis and autoimmune gastritis, but the absolute risks are unclear. The aim of this study was to investigate the prevalence of autoantibodies to tissue transglutaminase (TGA), thyroid peroxidase (TPOA) and gastric H+ /K+ -ATPase (ATPA) and their genetic associations in a well-characterized population-based cohort of individuals with T1D from the Bart's-Oxford family study for whom islet autoantibody prevalence data were already available. Autoantibodies in sera from 1072 patients (males/females 604/468; median age 11·8 years, median T1D duration 2·7 months) were measured by radioimmunoassays; HLA class II risk genotype was analysed in 973 (91%) using polymerase chain reaction with sequence specific primers (PCR-SSP). The prevalence of TGA (and/or history of CD), TPOA and ATPA in patients was 9·0, 9·6 and 8·2%, respectively; 3·1% had two or more autoantibodies. Females were at higher risk of multiple autoimmunity; TGA/CD were associated with younger age and TPOA with older age. ATPA were uncommon in patients under 5 years, and more common in older patients. Anti-glutamate decarboxylase autoantibodies were predictive of co-existing TPOA/ATPA. TGA/CD were associated with human leucocyte antigen (HLA) DR3-DQ2, with the DR3-DQ2/DR3-DQ2 genotype conferring the highest risk, followed by DR4-DQ8/DR4-DQ8. ATPA were associated with DR3-DQ2, DRB1*0404 (in males) and the DR3-DQ2/DR4-DQ8 genotype. TPOA were associated with the DR3-DQ2/DR3-DQ2 genotype. Almost one-quarter of patients diagnosed with T1D aged under 21 years have at least one other organ-specific autoantibody. HLA class II genetic profiling may be useful in identifying those at risk of multiple autoimmunity.
Asunto(s)
Autoanticuerpos/inmunología , Autoantígenos/inmunología , Autoinmunidad/genética , Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 1/inmunología , Proteínas de Unión al GTP/inmunología , Glutamato Descarboxilasa/inmunología , ATPasa Intercambiadora de Hidrógeno-Potásio/inmunología , Yoduro Peroxidasa/inmunología , Proteínas de Unión a Hierro/inmunología , Transglutaminasas/inmunología , Adolescente , Adulto , Enfermedad Celíaca/genética , Niño , Preescolar , Femenino , Predisposición Genética a la Enfermedad/genética , Antígenos HLA-DQ/genética , Antígeno HLA-DR3/genética , Humanos , Lactante , Masculino , Proteína Glutamina Gamma Glutamiltransferasa 2 , Radioinmunoensayo , Gastropatías/genética , Enfermedades de la Tiroides/genética , Reino Unido , Adulto JovenRESUMEN
The objects of study are the territory of the districts of the West Kazakhstan region of the Republic of Kazakhstan adjacent to the Kapustin Yar test site: Bokeyordinsky, Zhangalinsky, Zhanibeksky, Kaztalovsky, Akzhayiksky and Syrymsky. The purpose of the work is to conduct a radioecological survey of contaminated areas and to study the content of pollutants in environmental objects, biota (rodents, fish and biosubstrates of domestic animals) by physicochemical methods to assess the risk of the landfill's impact on biota and humans. This paper presents the results of expeditionary and laboratory research on the pollution of environmental objects in the areas adjacent to the landfill. Indicators of the gamma-survey of the levels of radiation background of the surveyed territories as well as data on pollution of soil, surface and ground waters, dominant forms of plants, biosubstrates (hair of domestic animals: camel, horse, cow) are given. The generally accepted research methods were used: standard sampling methods, radiological, atomic adsorption spectrophotometry, cytogenetic (micronucleus) method. A reconnaissance and radioecological examination of environmental objects was carried out using analytical methods, which made it possible to determine the quantitative content of toxic components, the content of priority pollutants and radioactive isotopes. It has been established that the values of the volumetric activity of natural and man-made radionuclides in soil samples, drinking water and biosubstrates (pet hair, human peripheral blood samples) from settlements correspond to the value of the control level for this region. The measurements of radiation activity by gamma radiation showed that along the perimeter of the surveyed territory of the test site and in nearby settlements the radiation level is in the range of 0.06-0.014 µSv/h. A slight excess of the level of radioactivity persists in the area near the fall of missiles in the Bokeyordin region. The investigated regions are characterized by an insignificant level of background radiation, the average DER value for the regions as a whole is 0.14 µSv/h. The absolute maximum, 0.73 µSv/h, was recorded at the points of missile impact in the Kaztal region.