Search

Some insulin-dependent diabetic (IDDM) patients develop severe forms of retinopathy. Putative risk factors such as hypertension, poor metabolic control, nephropathy and growth hormone levels do not fully explain the progress of retinopathy in these patients. It has been discussed whether there is a genetic marker, since some diabetic patients without any known predisposing risk factors develop severe retinopathy and others do not. In the present study, HLA-DR and DQ were compared in two patient groups with IDDM. One group consisted of patients with early-onset diabetes, with severe non-proliferative or proliferative retinopathy; the other group had no or only mild signs of retinopathy. High resolution HLA typing was carried out by polymerase chain reaction (PCR) and hybridization with allele specific probes. Alleles on the DR3-DQ2 haplotype, DRB1*0301, DQA1*0501 and DQB1*0201, were more frequent in patients with severe retinopathy. A difference was seen when combining certain alleles in the genotypes of DQA1*03/0501 (p> 0.05) and DQB1*0201/0302 (p< 0.01). The findings of the present study suggest that DQB1*0201/0302 is the strongest genetic marker for severe retinopathy and DRB1*0301/0401 only has a secondary influence when combined with this genotype. It seems as if IDDM patients who are positive for the genotype DR3-DQ2/DR4-DQ8 (DRB1*0301-DQA1*0501-DQB1*0201/DRB1*0401 -DQA1*03-DQB1*0302) are at greater risk of developing severe retinopathy. [Diabetologia (1996) 39: 1313–1317]

In Sweden, a precipitous rise in the incidence of celiac disease (CD) in children below two years of age occurred during 1985-1995 in Sweden. The period is well suited for investigating the socioeconomic and geographical distribution of CD in Sweden. Previous research on the importance of socioeconomic position (SEP) in CD has produced conflicting results. All singleton children born in Sweden 1987-1993 were identified in the Swedish Medical Birth Record. We linked several other national registries to obtain socioeconomic, medical, and demographic information. We applied multilevel (counties, municipalities, and individuals) logistic regression methods to quantify a possible geographical clustering of CD cases and to investigate the association between SEP and CD. Using equalized family income quintile groups as a measure of SEP, we found that in the lowest quintile group the association with CD was for boys OR 1.18 (95 % CI 0.90-1.55) and for girls OR 0.82 (95 % CI 0.67-1.00). Using the Median Odds Ratio (MOR) as a measure of geographical variation clustering, we found that for boys the MOR was 1.76 (95 % CrI 1.46-2.00) and for girls 1.92 (95 % CrI 1.49-2.30). We also identified a reduced odds of CD in offspring having a mother born outside Sweden, boys OR 0.75 (95 % CI 0.57-0.98) and girls OR 0.64 (95 % CI 0.51-0.79). The study show that SEP is of minor importance in the distribution of CD among small children. However, we identified a significant geographical clustering of CD in Sweden during 1987-1993.