Elevated positive rate of 21-hydroxylase antibodies in the population with type 1 diabetes mellitus: A meta-analysis

Objective Given that the autoimmune mechanism might be the common pathological basis for 21-hydroxylase antibody positivity and type 1 diabetes mellitus (T1DM), these two conditions may coexist in some patients. This meta-analysis aims to provide more reliable and powerful evidence by systematically integrating and analyzing the raw data of all relevant studies, in order to clarify whether there is a statistically significant association between 21-hydroxylase antibody positivity and T1DM.Methods To screen and evaluate relevant studies on the association between 21-hydroxylase antibodies and T1DM, we systematically searched the PubMed, Web of Science, CNKI, and CBM databases. The search period was set from January 1995 to December 2024, and the languages of the included literature were limited to English or Chinese. Based on the extracted data, the odds ratio (OR) and its 95% confidence interval (CI) and P value were calculated to assess the statistical association between the two.Results A total of 10 independent studies were included in this research, with a total of 2 852 T1DM patients and 1 596 non-diabetic control individuals. The results of the meta-analysis showed that the positive rate of 21-hydroxylase antibodies in T1DM patients was significantly higher than that in the control group (OR=3.35, 95%CI 1.80 to 6.24). The publication bias test did not detect any significant bias, and the sensitivity analysis further confirmed the stability and reliability of the analysis results.Conclusion The results of this meta-analysis indicate that the positive rate of 21-hydroxylase antibodies in T1DM patients is significantly higher compared to the non-diabetic control population, suggesting a potential immune association between the two. It is worthy of further exploration of the underlying mechanism in future studies.