背景:血清免疫球蛋白G4(IgG4)浓度升高是IgG4相关疾病(IgG4-RD)的特征性发现之一。这项研究调查了普通日本人群中血清IgG4水平升高的频率和相关因素。
方法:测量了石川县1,201名接受一般医学检查的居民的血清IgG4浓度。通过逻辑回归分析评估与血清IgG4浓度升高相关的因素。血清IgG4升高的参与者接受二次检查。
结果:平均血清IgG4浓度为44mg/dL,42(3.5%)参与者血清IgG4水平升高。年龄和性别调整逻辑回归分析显示,男性,年龄较大,日常饮食中脂质和多不饱和脂肪酸摄入量较低,碳水化合物摄入量较高与血清IgG4浓度升高相关.男性的亚组分析显示,年龄较大,基于血清胱抑素C(eGFR-cysC)水平的较低估计肾小球滤过率,血红蛋白A1c(HbA1c)水平升高与血清IgG4浓度升高相关。对女性的分析表明,较低的脂质和脂肪酸摄入量以及较高的碳水化合物摄入量与血清IgG4浓度升高显着相关。接受二级检查的15名参与者之一被诊断为可能的IgG4相关腹膜后纤维化。
结论:日本普通人群血清IgG4水平升高与年龄增长显著相关,男性,和膳食营养的摄入,其中一些因素与IgG4-RD的流行病学特征相同。
BACKGROUND: Elevated serum immunoglobulin G4 (IgG4) concentrations are one of the characteristic findings in IgG4-related disease (IgG4-RD). This study investigated the frequency of elevated serum IgG4 levels and associated factors in a general Japanese population.
METHODS: Serum IgG4 concentrations were measured in 1,201 residents of Ishikawa prefecture who underwent general medical examinations. Factors associated with elevated serum IgG4 concentrations were assessed by logistic regression analysis. Participants with elevated serum IgG4 were subjected to secondary examinations.
RESULTS: The mean serum IgG4 concentration was 44 mg/dL, with 42 (3.5%) participants having elevated serum IgG4 levels. Age- and sex-adjusted logistic regression analyses showed that male sex, older age, and lower intake of lipids and polyunsaturated fatty acids and higher intake of carbohydrates in daily diet were associated with elevated serum IgG4 concentration. Subgroup analyses in men showed that older age, lower estimated glomerular filtration rates based on serum cystatin C (eGFR-cysC) levels, and higher hemoglobin A1c (HbA1c) levels were associated with elevated serum IgG4 concentration. Analyses in women showed that lower intake of lipids and fatty acids and higher intake of carbohydrates were significantly associated with elevated serum IgG4 concentration. One of the 15 participants who underwent secondary examinations was diagnosed with possible IgG4-related retroperitoneal fibrosis.
CONCLUSIONS: Elevated serum IgG4 levels in a Japanese general population were significantly associated with older age, male gender, and dietary intake of nutrients, with some of these factors identical to the epidemiological features of IgG4-RD.