受影响的兄弟是儿童和青少年1型糖尿病发展的最高危险因素:在实施1型糖尿病全国筛查之前的一个中心数据。

IF 2.1 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Anna Wędrychowicz, Teresa Grzelak, Alicja Pietraszek, Maria Skrzyszowska, Mari Minasjan, Jerzy B Starzyk
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引用次数: 0

摘要

背景:当亲属中报告有T1D和2型糖尿病(T2D)时,儿童1型糖尿病(T1D)的风险增加。目的:我们的目的是在实施国家T1D筛查计划之前评估当前T1D发展的家庭危险因素。材料和方法:879名患有T1D的高加索儿童和青少年和286名健康对照者被纳入研究。所有参与者都完成了相同的问卷,收集了三代以上糖尿病家族史的信息。在统计分析中,频率表和χ2检验评估了与结果显著相关的危险因素之间可能存在的多重共线性。结果:对照组糖尿病家族史发生率(n = 75, 26.2%)高于T1D患者(n = 146, 16.6%,优势比(OR) = 1.785, 95%可信区间(95% CI): 1.499 -2.452,自由度(df) = 12.976, p = 0.004),尤其是T2D家族史发生率(n = 62, 21.7%,分别高于n = 79, 9.0%, OR = 2.803, 95% CI: 1.948-4.034, df = 32.669, p < 0.001)。此外,T1D患者的核心家庭更容易受到T1D的影响(n = 74, 8.4%),而对照组(n = 15, 5.2%, OR = 1.605, 95% CI: 0.937-2.751, df = 3.081, p = 0.079)。患T1D的风险与最亲密的家庭成员受到影响有关,并且随着年龄的增长而增加。的确,在兄弟姐妹中发病率最高,尤其是兄弟姐妹(OR = 12.985, 95% CI: 0.782-215.743, Fisher检验:p < 0.001)。对照组二度亲属中T2D负担家族史阳性的发生率是T1D组的2.728倍(OR = 2.728;95% Cl: 1.880 ~ 3.962, p < 0.001)。此外,与T1D组相比,对照组一级亲属中T1D家族史阳性的发生率较低(OR = 0.124;95% Cl: 0.030-0.516, p = 0.004)。结论:T1D家族史是T1D发展的重要危险因素,而非T2D家族史。事实上,T1D筛查应优先考虑T1D患者的一级亲属,从兄弟姐妹开始。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Affected brother as the highest risk factor of type 1 diabetes development in children and adolescents: One center data before implementing type 1 diabetes national screening.

Background: There is an increased risk for childhood type 1 diabetes (T1D) when T1D and type 2 diabetes (T2D) are reported in relatives.

Objectives: Our objective was to evaluate current family risk factors for T1D development before implementing a national screening program for T1D.

Material and methods: A population of 879 Caucasian children and adolescents with T1D and 286 healthy controls were enrolled in the study. All participants completed the same questionnaire, which collected information about family history of diabetes over 3 generations. In statistical analyses, frequency tables and χ2 tests evaluated possible multicollinearity among risk factors that were significantly associated with the outcomes.

Results: Family history of diabetes was more frequent in controls (n = 75, 26.2%) than in patients with T1D (n = 146, 16.6%, odds ratio (OR) = 1.785, 95% confidence interval (95% CI): 1.299-2.452, degrees of freedom (df) = 12.976, p = 0.004), especially with a family history of T2D (n = 62, 21.7% compared to n = 79, 9.0%, respectively, OR = 2.803, 95% CI: 1.948-4.034, df = 32.669, p < 0.001). Also, there was a tendency for the nuclear family of T1D patients to be more frequently affected by T1D (n = 74, 8.4%) than the controls (n = 15, 5.2%, OR = 1.605, 95% CI: 0.937-2.751, df = 3.081, p = 0.079). The risk of T1D was associated with the closest family members being affected and accelerated over generations. Indeed, it was highest in siblings, especially brothers (OR = 12.985, 95% CI: 0.782-215.743, Fisher's test: p < 0.001). A positive family history of T2D burden among second-degree relatives was 2.728 times more frequent in the control group than in the T1D group (OR = 2.728; 95% Cl: 1.880-3.962, p < 0.001). Furthermore, a positive family history of T1D among first-degree relatives was less frequent in the controls than in the T1D group (OR = 0.124; 95% Cl: 0.030-0.516, p = 0.004).

Conclusions: A family history of T1D, but not T2D, is a significant risk factor for T1D development. Indeed, the priority in screening for T1D should be given to first-degree relatives of T1D patients, starting from siblings.

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来源期刊
Advances in Clinical and Experimental Medicine
Advances in Clinical and Experimental Medicine MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
3.70
自引率
4.80%
发文量
153
审稿时长
6-12 weeks
期刊介绍: Advances in Clinical and Experimental Medicine has been published by the Wroclaw Medical University since 1992. Establishing the medical journal was the idea of Prof. Bogumił Halawa, Chair of the Department of Cardiology, and was fully supported by the Rector of Wroclaw Medical University, Prof. Zbigniew Knapik. Prof. Halawa was also the first editor-in-chief, between 1992-1997. The journal, then entitled "Postępy Medycyny Klinicznej i Doświadczalnej", appeared quarterly. Prof. Leszek Paradowski was editor-in-chief from 1997-1999. In 1998 he initiated alterations in the profile and cover design of the journal which were accepted by the Editorial Board. The title was changed to Advances in Clinical and Experimental Medicine. Articles in English were welcomed. A number of outstanding representatives of medical science from Poland and abroad were invited to participate in the newly established International Editorial Staff. Prof. Antonina Harłozińska-Szmyrka was editor-in-chief in years 2000-2005, in years 2006-2007 once again prof. Leszek Paradowski and prof. Maria Podolak-Dawidziak was editor-in-chief in years 2008-2016. Since 2017 the editor-in chief is prof. Maciej Bagłaj. Since July 2005, original papers have been published only in English. Case reports are no longer accepted. The manuscripts are reviewed by two independent reviewers and a statistical reviewer, and English texts are proofread by a native speaker. The journal has been indexed in several databases: Scopus, Ulrich’sTM International Periodicals Directory, Index Copernicus and since 2007 in Thomson Reuters databases: Science Citation Index Expanded i Journal Citation Reports/Science Edition. In 2010 the journal obtained Impact Factor which is now 1.179 pts. Articles published in the journal are worth 15 points among Polish journals according to the Polish Committee for Scientific Research and 169.43 points according to the Index Copernicus. Since November 7, 2012, Advances in Clinical and Experimental Medicine has been indexed and included in National Library of Medicine’s MEDLINE database. English abstracts printed in the journal are included and searchable using PubMed http://www.ncbi.nlm.nih.gov/pubmed.
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