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血清转化到多个小岛自身抗体和儿童糖尿病进展的风险
Anette G Ziegler1, Marian Rewers, Olli Simell
1Institute of Diabetes Research, Helmholtz Zentrum München, and Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Ingolstaedter Landstrase 1, Neuherberg, Germany 85764. anette-g.ziegler@helmholtz-muenchen.de
JAMA
|June 20, 2013
概括
大多数患有多个小岛自身抗体的儿童在15年内会患上1型糖尿病. 早期血清转化 (3岁以下),特定的HLA基因型,以及女性增加这种风险. 预防工作应该针对这个高风险群体.
科学领域:
- 内分泌学 在内分泌学.
- 免疫学 免疫学 免疫学
- 儿科 儿科 儿科
背景情况:
- 1型糖尿病有一个临床前阶段,标志着小岛自身抗体.
- 自体抗体血清转换后发展为1型糖尿病的速度尚未确立.
研究的目的:
- 为了确定风险儿童在岛屿自身抗体血清转换后进展到1型糖尿病的速度.
主要方法:
- 来自科罗拉多州,芬兰和德国的前性队列研究的数据.
- 包括具有1型糖尿病遗传风险的儿童,对自身抗体 (胰岛素,GAD65,IA2) 的监测和糖尿病诊断.
- 追踪参与者直到2012年7月,根据自身抗体数量和血清转化时的年龄分析进展情况.
主要成果:
- 在10年的随访中,69.7%的多个小岛自身抗体的儿童发展为1型糖尿病.
- 有单个自身抗体的儿童中有14.5%的糖尿病进展,而只有0.4%没有自身抗体的儿童在15岁时患上了糖尿病.
- 在3岁前血清转化 (74.9%的10年风险),HLA-DR3/DR4-DQ8 (76.6%的10年风险) 和女孩 (74.8%的10年风险) 的儿童中,进展更快.
结论:
- 大多数患有多个小岛自身抗体的儿童将在15年内患上1型糖尿病.
- 早期血清转化,特定的HLA基因型和女性性别与更快的进展有关.
- 未来的1型糖尿病预防研究应该优先考虑这种高风险人群.
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