Autoimmune polyglandular syndrome among Chinese Celiac disease patients: A Survey of 243 Individuals in China

Sheng Long Xue¹Yan Feng²Tian Shi²Halina Halike²Ayinuer Maimaitireyimu²Adilai Abudurexiti²Jinjin Xie³Shanxia Yao⁴Feng Gao^2*

• ¹Department of Gastroenterology, People’s Hospital of Xinjiang Uygur Autonomous Region, College of Life Science and Technology, Xinjiang University, Urumqi, China
• ²Department of Gastroenterology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
• ³Xinjiang Medical University, Ürümqi, Xinjiang Uyghur Region, China
• ⁴Xinjiang University, Urumqi, Xinjiang Uyghur Region, China

Background: Celiac disease (CeD), an autoimmune enteropathy, is often associated with multiple glandular autoimmune diseases. However, the prevalence and staging characteristics of autoimmune polyglandular syndrome (APS) among CeD patients remain unclear. The aim of this study was to assess the prevalence and clinical features of APS among Chinese CeD patients. Methods: Clinical data and medical records of 243 CeD patients diagnosed in northwest China were retrospectively analyzed to identify comorbid autoimmune diseases among CeD patients. Serum interferon-ω1, interferon-α, and thyroid autoantibodies (TPOAb and TgAb) were measured, and AIRE mutations were detected. APS typing was conducted based on serum antibodies, gene sequencing (AIRE mutation analysis), and comorbidity analysis.The overall prevalence of APS in CeD patients was 10.3% (25/243), and the prevalence of different types of APS varied as follows: APS-1: 0.4%, APS-2: 0.4%, APS-3: 8.2%, and APS-4: 1.2%. The prevalence of APS in CeD patients was significantly higher than that in the general population, especially the prevalence of APS-3. Patients with CeD combined with APS had a higher prevalence of vitamin D deficiency (13 of 25 patients, 52%) and H. pylori infection (8 of 25 patients, 32%). In addition, CeD patients with combined APS were more likely to have anxiety and depressive symptoms (P < 0.05), but there were no significant differences in gender, ethnicity, or body mass index.This study is the first to systematically evaluate the prevalence and staging characteristics of APS among CeD patients, thereby filling the epidemiological data gap in this area. We emphasize the significance of screening for APS among CeD patients to enable early detection and treatment of associated autoimmune diseases and enhance patients' quality of life.