Cesarean section and interferon-induced helicase gene polymorphisms combine to increase childhood type 1 diabetes risk.
Cesarean section and interferon-induced helicase gene polymorphisms combine to increase childhood type 1 diabetes risk.
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DOI：
10.2337/db11-0729
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发表时间：
2011-12
期刊：
影响因子：
7.7
通讯作者：
Ziegler AG
中科院分区：
文献类型：
--
作者：
Bonifacio E;Warncke K;Winkler C;Wallner M;Ziegler AG
1型糖尿病的发病率正在上升。剖腹产分娩也更普遍，并且表明剖腹产与1型糖尿病风险相关。我们研究了剖宫产、胰岛自身免疫和1型糖尿病之间的关系，以及与1型糖尿病易感性相关的基因。研究人员对1,650名患有1型糖尿病的父母所生的儿童进行了剖腹产检查，并从出生时开始跟踪胰岛自身抗体和1型糖尿病的发展。剖宫产分娩的儿童（n = 495）患1型糖尿病的风险比阴道分娩的儿童高两倍以上（风险比[HR] 2.5; 95%CI 1.4-4.3; P = 0.001）。剖腹产并没有增加胰岛自身抗体的风险（P = 0.6），但与出现自身免疫后更快进展为糖尿病相关（P = 0.015）。剖宫产相关风险独立于潜在混杂变量（校正HR 2.7;1.5-5.0; P = 0.001），并在有和无高危HLA基因型的儿童中观察到。有趣的是，剖腹产似乎与免疫应答基因相互作用，包括CD 25，特别是干扰素诱导的解旋酶1基因，其中仅在通过剖腹产分娩并具有1型糖尿病易感IFIH 1基因型的儿童中观察到1型糖尿病风险增加（12年风险，9.1 vs. <3%，所有其他组合; P < 0.0001）。这些研究结果表明，1型糖尿病的风险修改剖宫产可能与病毒反应在临床前自身抗体阳性的疾病阶段。
The incidence of type 1 diabetes is increasing. Delivery by cesarean section is also more prevalent, and it is suggested that cesarean section is associated with type 1 diabetes risk. We examine associations between cesarean delivery, islet autoimmunity and type 1 diabetes, and genes involved in type 1 diabetes susceptibility. Cesarean section was examined as a risk factor in 1,650 children born to a parent with type 1 diabetes and followed from birth for the development of islet autoantibodies and type 1 diabetes. Children delivered by cesarean section (n = 495) had more than twofold higher risk for type 1 diabetes than children born by vaginal delivery (hazard ratio [HR] 2.5; 95% CI 1.4–4.3; P = 0.001). Cesarean section did not increase the risk for islet autoantibodies (P = 0.6) but was associated with a faster progression to diabetes after the appearance of autoimmunity (P = 0.015). Cesarean section–associated risk was independent of potential confounder variables (adjusted HR 2.7;1.5–5.0; P = 0.001) and observed in children with and without high-risk HLA genotypes. Interestingly, cesarean section appeared to interact with immune response genes, including CD25 and in particular the interferon-induced helicase 1 gene, where increased risk for type 1 diabetes was only seen in children who were delivered by cesarean section and had type 1 diabetes–susceptible IFIH1 genotypes (12-year risk, 9.1 vs. <3% for all other combinations; P < 0.0001). These findings suggest that type 1 diabetes risk modification by cesarean section may be linked to viral responses in the preclinical autoantibody-positive disease phase.
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影响因子：
7.7
作者：
Lipponen K;Gombos Z;Kiviniemi M;Siljander H;Lempainen J;Hermann R;Veijola R;Simell O;Knip M;Ilonen J
通讯作者：
Ilonen J
DOI：
10.1136/bmj.c5065
发表时间：
2010-10-06
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Bragg F;Cromwell DA;Edozien LC;Gurol-Urganci I;Mahmood TA;Templeton A;van der Meulen JH
通讯作者：
van der Meulen JH
影响因子：
8.2
作者：
Gale, EAM
通讯作者：
Gale, EAM
影响因子：
2.5
作者：
Huurre, Anu;Kalliomaki, Marko;Isolauri, Erika
通讯作者：
Isolauri, Erika
影响因子：
16.2
作者：
PATTERSON, CC;WAUGH, NR;HADDEN, DR
通讯作者：
HADDEN, DR