Predictors of IDDM recurrence risk in offspring of Danish IDDM patients
Predictors of IDDM recurrence risk in offspring of Danish IDDM patients
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DOI：
10.1007/s001250050966
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发表时间：
1998-06-01
期刊：
影响因子：
8.2
通讯作者：
Nerup, J
中科院分区：
文献类型：
--
作者：
Lorenzen, T;Pociot, F;Nerup, J
此前已经观察到，患有胰岛素依赖型糖尿病(IDDM)的母亲的子女患IDDM的风险低于受IDDM影响的父亲的子女。为了在一项基于丹麦人群的研究中评估后代IDDM复发的风险，并调查可能影响这种风险的父母和子女相关的生物学变量，我们从172.5万人(占丹麦人口的33%)的背景人口中确定了2726名IDDM先证者及其2826名后代。先证者目前的年龄为20-65岁，他们发病时的年龄不超过30岁。69名子女(2.4%)患有IDDM。证实IDDM亲子传播率存在性别差异。仅当父母在子女出生前被诊断为IDDM时，母亲子女30岁以下的累积IDDM风险显著低于父亲子女(2.3+/-0.6%和5.7+/-0.9%，RR=2.4，95%可信区间1.30-4.47；P=0.004)。然而，由于先证者出生后被诊断为IDDM的糖尿病后代数量较少，这一观察结果需要在更大的人群中得到证实。在父母均在子女出生前被诊断为IDDM的2380名子女中，17岁以下确诊为男性先证者的子女的复发风险显著高于年龄较大的父亲的子女(8.5%+/-1.8%和3.6%+/-1.0%；RR=2.27，95%CI1.21-4.25；p=0.006)。在母亲的子代中没有发现这种关系，对这个子代亚群使用Cox比例风险模型，我们发现父亲发病时的年龄是IDDM复发风险的唯一有统计学意义的预测因素。我们的发现可能对父母一方患有IDDM的家庭的咨询很重要。
It has previously been observed that offspring of mothers with insulin-dependent diabetes mellitus (IDDM) have a lower risk of IDDM than offspring of IDDM affected fathers. To assess the offspring IDDM recurrence risk in a Danish population-based study and to investigate parental and offspring-related biological variables that might influence this risk, we identified 2726 IDDM probands and their 2826 offspring from a background population of 1.725 million people (33% of the Danish population). Current age of probands was 20-65 years and their age at IDDM onset was 30 years or less. Sixty nine offspring (2.4%) were affected with IDDM. The sex difference in the parental-offspring IDDM transmission rate was confirmed. The cumulative IDDM risk up to age 30 years was found to be significantly decreased in maternal offspring compared to paternal offspring (2.3 +/- 0.6 and 5.7 +/- 0.9%, RR = 2.40, 95% CI 1.30-4.47; p = 0.004) only if parents were diagnosed with IDDM before birth of the offspring. However, due to the low number of diabetic offspring of probands diagnosed with IDDM after offspring birth, this observation needs to be confirmed in a larger population. In a subpopulation of the 2380 offspring, whose parents were all diagnosed with IDDM before offspring birth, the recurrence risk was significantly increased in offspring of male probands diagnosed up to age 17 years compared to offspring of fathers diagnosed at older ages (8.5 +/- 1.8 and 3.6 +/- 1.0%; RR = 2.27, 95% CI 1.21-4.25; p = 0.006). No such relation was found in maternal offspring, Using the Cox proportional hazards model on this offspring subpopulation we found that paternal age at IDDM onset was the only statistically significant predictor of IDDM recurrence risk. Our findings may be important for counselling families in which one parent has IDDM.