Birthweight and the risk of childhood-onset type 1 diabetes: a meta-analysis of observational studies using individual patient data
Birthweight and the risk of childhood-onset type 1 diabetes: a meta-analysis of observational studies using individual patient data
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DOI：
10.1007/s00125-009-1648-5
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发表时间：
2010-04-01
期刊：
影响因子：
8.2
通讯作者：
Patterson, C. C.
中科院分区：
文献类型：
--
作者：
Cardwell, C. R.;Stene, L. C.;Patterson, C. C.
我们调查了出生时体重较重的儿童患1型糖尿病的风险是否增加。2009年2月之前发表的相关研究是从MEDLINE、Web of Science和EMBASE的文献搜索中确定的。所有包含相关数据的研究的作者都被联系，并被要求提供单个患者的数据或进行预先指定的分析。在调整潜在混杂因素之前和之后，计算每项研究中按出生体重类别分类的1型糖尿病的风险估计。Meta分析技术随后被用来得出合并的OR并调查研究之间的异质性。数据来自29个主要的欧洲研究(5个队列，24个病例对照研究)，包括12,807例1型糖尿病病例。总体而言，研究一致地表明，与出生时体重在3.0至3.5公斤之间的儿童相比，出生体重在3.5至4公斤之间的儿童患糖尿病的风险增加了6%(OR1.06[95%可信区间1.01-1.11]；p=0.02)，而出生体重超过4公斤的儿童患糖尿病的风险增加了10%(OR1.10[95%可信区间1.04-1.19]；p=0.003)。这对应于出生体重每增加500克，糖尿病风险线性增加3%(OR 1.03[95%CI 1.00-1.06]；p=0.03)。调整潜在的混杂因素，如胎龄、母亲年龄、出生顺序、剖腹产、母乳喂养和母亲糖尿病对这些发现几乎没有影响。出生时体重较重的儿童患1型糖尿病的风险增加显著且一致，但相对较小。
We investigated whether children who are heavier at birth have an increased risk of type 1 diabetes.Relevant studies published before February 2009 were identified from literature searches using MEDLINE, Web of Science and EMBASE. Authors of all studies containing relevant data were contacted and asked to provide individual patient data or conduct pre-specified analyses. Risk estimates of type 1 diabetes by category of birthweight were calculated for each study, before and after adjustment for potential confounders. Meta-analysis techniques were then used to derive combined ORs and investigate heterogeneity between studies.Data were available for 29 predominantly European studies (five cohort, 24 case-control studies), including 12,807 cases of type 1 diabetes. Overall, studies consistently demonstrated that children with birthweight from 3.5 to 4 kg had an increased risk of diabetes of 6% (OR 1.06 [95% CI 1.01-1.11]; p = 0.02) and children with birthweight over 4 kg had an increased risk of 10% (OR 1.10 [95% CI 1.04-1.19]; p = 0.003), compared with children weighing 3.0 to 3.5 kg at birth. This corresponded to a linear increase in diabetes risk of 3% per 500 g increase in birthweight (OR 1.03 [95% CI 1.00-1.06]; p = 0.03). Adjustments for potential confounders such as gestational age, maternal age, birth order, Caesarean section, breastfeeding and maternal diabetes had little effect on these findings.Children who are heavier at birth have a significant and consistent, but relatively small increase in risk of type 1 diabetes.