Prevalence of Celiac Disease and Gluten Sensitivity in the United States Clinical Antipsychotic Trials of Intervention Effectiveness Study Population
Prevalence of Celiac Disease and Gluten Sensitivity in the United States Clinical Antipsychotic Trials of Intervention Effectiveness Study Population
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DOI：
10.1093/schbul/sbp055
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发表时间：
2011-01-01
影响因子：
6.6
通讯作者：
Eaton, William W.
中科院分区：
文献类型：
--
作者：
Cascella, Nicola G.;Kryszak, Debra;Eaton, William W.
乳糜泻（CD）和精神分裂症的患病率大致相同，但流行病学数据显示，精神分裂症患者的CD患病率更高。这种高发生率的原因尚不清楚，但关于精神分裂症患者乳糜泻或麸质不耐受的免疫标记物存在的临床知识可能对治疗有影响。我们的目的是评估一组精神分裂症患者和对照组中麦胶蛋白（AGA）、转谷氨酰胺酶（tTG）和肌内膜（EMA）抗体的流行情况。在1401名精神分裂症患者和900名对照组中检测了AGA、tTG和EMA抗体，这些患者是临床抗精神病药物干预有效性研究的一部分。采用阳性和阴性症状量表（PANSS）评估精神分裂症患者的精神病理。采用Logistic回归评估AGA、免疫球蛋白A （IgA）和tTG抗体频率的差异，并根据年龄、性别和种族进行调整。采用线性回归预测AGA和tTG抗体的PANSS评分，并根据年龄、性别和种族进行调整。在精神分裂症患者中，23.1%的患者IgA-AGA水平中高，而对照组为3.1% （chi(2) = 1885, df = 2, P < 0.001）。5.4%的精神分裂症患者存在中高水平的tTG抗体，而对照组为0.80% （chi(2) = 392.0, df = 2, P < 0.001）。性别、年龄和种族的调整对差异影响不大。回归分析无法预测AGA和tTG抗体的PANSS评分。精神分裂症患者与乳糜泻和麸质敏感性相关的抗体滴度高于预期。
Celiac disease (CD) and schizophrenia have approximately the same prevalence, but epidemiologic data show higher prevalence of CD among schizophrenia patients. The reason for this higher co-occurrence is not known, but the clinical knowledge about the presence of immunologic markers for CD or gluten intolerance in schizophrenia patients may have implications for treatment. Our goal was to evaluate antibody prevalence to gliadin (AGA), transglutaminase (tTG), and endomysium (EMA) in a group of individuals with schizophrenia and a comparison group. AGA, tTG, and EMA antibodies were assayed in 1401 schizophrenia patients who were part of the Clinical Antipsychotic Trials of Intervention Effectiveness study and 900 controls. Psychopathology in schizophrenia patients was assessed using the Positive and Negative Symptoms Scale (PANSS). Logistic regression was used to assess the difference in the frequency of AGA, immunoglobulin A (IgA), and tTG antibodies, adjusting for age, sex, and race. Linear regression was used to predict PANSS scores from AGA and tTG antibodies adjusting for age, gender, and race. Among schizophrenia patients, 23.1% had moderate to high levels of IgA-AGA compared with 3.1% of the comparison group (chi(2) = 1885, df = 2, P < .001.) Moderate to high levels of tTG antibodies were present in 5.4% of schizophrenia patients vs 0.80% of the comparison group (chi(2) = 392.0, df = 2, P < .001). Adjustments for sex, age, and race had trivial effects on the differences. Regression analyses failed to predict PANSS scores from AGA and tTG antibodies. Persons with schizophrenia have higher than expected titers of antibodies related to CD and gluten sensitivity.