Comorbidity of Type 1 Diabetes Mellitus in Patients with Juvenile Idiopathic Arthritis
Comorbidity of Type 1 Diabetes Mellitus in Patients with Juvenile Idiopathic Arthritis
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DOI：
10.1016/j.jpeds.2017.07.050
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发表时间：
2018-01-01
影响因子：
5.1
通讯作者：
Thon, Angelika
中科院分区：
文献类型：
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作者：
Schenck, Sandra;Rosenbauer, Joachim;Thon, Angelika
目的确定幼年特发性关节炎（JIA）患者中1型糖尿病（T1 D）的患病率，并对两者均具有的患者进行特征化。研究设计自2012年以来，国家儿科风湿病数据库中记录了糖尿病合并症。来自北莱茵-威斯特伐利亚糖尿病登记处的数据作为一般人群中糖尿病患病率的参考人群。国家儿童风湿病数据库的数据间接标准化的年龄和性别与一般人群进行比较。采用Poisson回归模型计算糖尿病患病率。共58例患者合并T1 D，糖尿病患病率为0.5%。记录时平均年龄为11.6岁，平均病程为4.2年。与普通人群相比，JIA患者的糖尿病患病率显著增加（患病率比1.76 [95%CI 1.34; 2.28]，P <0.001）。JIA患者的糖尿病发病早于文献报道。63%的患者在JIA之前发展为T1 D。平均而言，糖尿病的发病时间比JIA的发病时间早56个月。首次出现JIA的患者平均在40个月后出现T1 D。大多数患者在糖尿病发病前没有接受过改善病情的抗风湿药物治疗。结论T1 D在JIA患者中的发生率高于一般人群。T1 D发生的可能性似乎在JIA表现之前略高，并且在JIA发作后没有进行疾病缓解抗风湿药物治疗。
Objectives To determine the prevalence of type 1 diabetes mellitus (T1D) in patients with juvenile idiopathic arthritis (JIA) and to characterize patients having both.Study design Diabetes comorbidity was recorded in the National Pediatric Rheumatologic Database since 2012. Data from the North Rhine-Westphalian diabetes registry served as the reference population for the prevalence of diabetes in the general population. The National Pediatric Rheumatologic Database data were indirectly standardized for age and sex for comparison with the general population. The diabetes prevalence ratio was calculated using the Poisson regression model.Results The analysis included 12 269 patients with JIA. A total of 58 patients had comorbid T1D, and the diabetes prevalence was 0.5%. The mean age was 11.6 years at the time of documentation, and the mean disease duration was 4.2 years. Compared with the general population, the prevalence of diabetes in patients with JIA was significantly increased (prevalence ratio 1.76 [95% CI 1.34; 2.28], P < .001). The onset of diabetes in patients with JIA was earlier than that reported in the reference data. Sixty-three percent of patients developed T1D before JIA. On average, diabetes onset was 56 months before the onset of JIA. Patients who first developed JIA developed T1D on average 40 months later. The majority of patients had not received disease-modifying antirheumatic drugs before diabetes onset.Conclusions T1D occurs more frequently in patients with JIA than in the general population. The likelihood of T1D occurrence appears to be slightly higher before JIA manifestation and without disease-modifying antirheumatic drug therapy after JIA onset.