儿童1型糖尿病生命早期相关影响因素的病例对照研究

Case-control study of early life-related risk factors associated with type 1 diabetes mellitus in children

目的探讨儿童1型糖尿病(T1DM)发生的影响因素,为有针对性采取防治措施提供参考。方法采用病例对照研究,选取沈阳市某医院106例确诊为T1DM的患儿为病例组,同期按照年龄、性别、居住地区1:1匹配的原则,选取106名健康儿童作为对照组,对两组生命早期可能影响T1DM发生发展的因素进行问卷调查。结果 106例T1DM患儿平均确诊年龄为(8.02±3.49)岁;女童占60.4%,男童占39.6%。多因素Logistic回归分析显示,家庭经济好、父亲文化程度高与T1DM的发生呈负相关;而家庭成员吸烟(OR=2.51, 95%CI=1.19~5.29)、有糖尿病家族史(OR=2.56, 95%CI=1.18~5.55)、母亲肥胖(OR=5.42, 95%CI=2.49~11.83)和孕期感染(OR=3.45, 95%CI=1.04~11.46)与T1DM发生呈正相关(P值均<0.05)。结论儿童T1DM的发生受遗传、母孕期健康及家庭经济等多因素的影响,从生命早期开始预防儿童T1DM的发生具有重要意义。

Objective To investigate the affecting factors of type 1 diabetes mellitus(T1 DM) in children, and to provide reference for the prevention and treatment measures in the future. Methods A case-control study was carried out among 106 children diagnosed with T1 DM in a hospital in Shenyang. At the same time, 106 healthy children were selected as the control group by 1∶1 matching of age, gender and living area. The early life-related factors that may affect the development of T1 DM in two groups were investigated by questionnaire. Results The average age of diagnosis in 106 cases with T1 DM was(8.02±3.49) years, girls accounted for 60.4% and boys 39.6%. Multi-factor Logistic regression analysis showed that high family socioeconomic status and higher education of fathers were associated with lower odds of development of T1 DM. Family member smoking(OR=2.51, 95%CI=1.19-5.29), family history of diabetes(OR=2.56, 95%CI=1.18-5.55), maternal obesity(OR=5.42, 95%CI=2.49-11.83) and infection during pregnancy(OR=3.45, 95%CI=1.04-11.46) were associated with higher risk of T1 DM(P<0.05). Conclusion The occurrence of T1 DM in children is affected by many factors including heredity, maternal health during pregnancy and family economy,highlighting the importance of early life prevention of T1 DM.