Intrauterine growth pattern and risk of childhood onset insulin dependent (type I) diabetes: Population based case-control study
Intrauterine growth pattern and risk of childhood onset insulin dependent (type I) diabetes: Population based case-control study
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DOI：
10.1136/bmj.313.7066.1174
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发表时间：
1996-11-09
影响因子：
--
通讯作者：
Kallen, B
中科院分区：
文献类型：
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作者：
Dahlquist, G;Bennich, SS;Kallen, B
目的-调查产前生长是否影响儿童期发病的胰岛素依赖型（I 型）糖尿病的风险。设计-基于人群的病例对照研究。背景-将全国儿童糖尿病病例登记处的数据与全国瑞典医疗出生登记处的数据联系起来。受试者-研究了 1973 年以后出生并在 1978 年至 1992 年诊断为糖尿病的总共 4584 名糖尿病儿童的数据。对于每个患有胰岛素依赖型糖尿病的儿童，从与先证者同年、在同一家医院出生的所有婴儿中随机选择三名对照儿童。主要结局指标——出生、体重、妊娠、母亲年龄和产次、既往自然流产次数以及按孕周计算的性别特定出生体重（以标准差（SD）的倍数表示）。结果——根据出生体重的 SD，儿童期发病糖尿病的比值比有明显的趋势。根据产妇年龄、产次、吸烟习惯和母亲糖尿病进行分层后，小于胎龄儿的比值比（95% 置信区间）为 0.81（0.65 至 0.99），经过类似分层后，大于胎龄儿的比值比（95% 置信区间）为 1.20（1.02 至 1.42）。结论 - 影响产前生长的宫内条件似乎也会以先前描述的方式影响儿童患糖尿病的风险对于产后生长：生长不良会降低风险，生长过度会增加风险。这种关联的机制尚不清楚。
Objective-To investigate whether prenatal growth affects the risk of development of childhood onset insulin dependent (type I) diabetes mellitus.Design-Population based case-control study.Setting-Data from a nationwide childhood diabetes case register were linked with data from the nationwide Swedish Medical Birth Registry.Subjects-Data from a total of 4584 diabetic children born after 1973 and diagnosed with diabetes from 1978 to 1992 were studied. For each child with insulin dependent diabetes three control children were randomly selected from among all infants born in the same year and at the same hospital as the proband.Main outcome measures-Birth, weight, gestation, maternal age and parity, number of previous spontaneous abortions, and sex specific birth weight by gestational week expressed as multiples of the standard deviation (SD).Results-There was a clear trend in the odds ratio for childhood onset diabetes according to SD of birth weight. The odds ratio (95% confidence interval) for small for gestational age after stratification for maternal age, parity, smoking habits, and maternal diabetes was 0.81 (0.65 to 0.99) and for large for gestational age after similar stratification was 1.20 (1.02 to 1.42).Conclusions-Intrauterine conditions that affect prenatal growth seem also to affect the risk of development of childhood diabetes in the way previously described for postnatal growth: a poor growth decreases and an excess growth increases the risk. The mechanism for this association is unclear.