JUVENILE DIABETES MELLITUS EPIDEMIOLOGY AND ETIOLOGY

这项拟议的研究是我们对 胰岛素依赖型糖尿病(IDDM)的流行病学和病因学。 具体地说，这项研究旨在解决四个具体领域。这个 首先是继续维护我们的注册表。这将使我们能够 研究20年间(1965-1985年)IDDM的流行病学情况。在……里面 此外，超过2000例病例和8000名一级亲属的登记 形成我们基因和新陈代谢研究的人口库。第二 AIM旨在检查IDDM的异质性，特别是 关于遗传标记。具体地说，我们将确定案件是否 具有不同遗传标记的人有不同的流行病学。如果这是 诚然，这可能意味着IDDM疾病的变种或不同的疾病。我们 不仅将测量人类白细胞抗原，还将测量其他遗传标记，包括 IG同种异型和KIDD。第三个具体目标旨在确定 与IDDM病例的遗传相似性与风险增加相关，并且 代谢变化以及这种变化是否会持续到 成人期。此外，这是为了确定是否存在 人类白细胞抗原(HL A)、免疫球蛋白(Ig)和/或基德(Kidd)与IDDM有关。第四个领域的调查将试图 为了记录在IDDM发展之前的事件 病例的非糖尿病同胞的危险组。我们的兴趣是 前瞻性地确定病例同胞中的IDDM危险因素。它是 我们在这四个方面的目标是也能够监测IDDM的发病率 以确定遗传、免疫学和环境的性质 产生胰岛素依赖型糖尿病的成分。最后一个领域 研究将对大约100个家庭进行更深入的调查， 胰岛素依赖型和非胰岛素依赖型糖尿病的报道 特别侧重于对这些家庭中的糖尿病类型进行分类。

The proposed research is a renewal for our investigation of the epidemiology and etiology of insulin dependent diabetes mellitus (IDDM). Specifically, the research is designed to address four specific areas. The first is to continue to maintain our registries. This will enable us to examine the epidemiology of IDDM over a 20 year period (1965-1985). In addition, the registries of over 2000 cases and 8000 first degree relatives form the population pool for our genetic and metabolic studies. The second aim is designed to examine the heterogeneity of IDDM in particular with regard to genetic markers. Specifically, we will determine whether cases with different genetic markers have a different epidemiology. If this were true, this may suggest IDDM disease variants or different diseases. We will not only be measuring HLA, but also other genetic markers, including Ig allotypes and Kidd. The third specific aim is designed to determine if genetic similarity to IDDM cases is associated with increased risk, and metabolic alterations and whether such changes are maintained into adulthood. Moreover, this is designed to determine if there is linkage of HLA, Ig and/or Kidd to IDDM. The fourth area of investigation will attempt to document the events that precede the development of IDDM in the high risk group of non-diabetic siblings of cases. The interest is to prospectively identify IDDM risk factors among siblings of cases. It is our goal with these four aims to be able to monitor IDDM incidence as well as to determine the nature of the genetic, immunologic and environmental components that produce insulin dependent diabetes. A final area of research is to examine in more depth approximately 100 families where both insulin dependent and non-insulin dependent diabetes mellitus are reported with particular focus on classifying the type of diabetes in these families.