Disease concurrence in type 1 diabetes

描述（由申请人提供）：本研究通过研究疾病并发模式，特别是与其他自身免疫性疾病（AD）的并发模式，探索1型糖尿病（T1D）的病因学。疾病并发——个体同时患有两种或两种以上疾病——是自身免疫的一个显著特征，尤其是T1D。在初步研究中，我们建立了方法来获得第一个真正的基于人群的疾病并发患病率，并量化疾病并发模式的程度，长期以来被认为是自身免疫性疾病的特征。ad之间的关系实际上构成了一系列相互关联的疾病，由于遗传环境（包括传染因子）、性相关和早期生活条件因素的相互作用，被认为反映了共同的潜在致病因素。通过对AD并发性的研究，可以揭示和量化这些因素对T1D的相对重要性。将对瑞典全国人口健康数据库（包括两个糖尿病登记处、住院出院登记处、出生登记处和癌症登记处）进行统计分析，以揭示T1D疾病并发模式的相似性和差异性。跨登记个体的联系将允许评估T1D疾病并发性和有影响的辅助因素，如出生体重。通过检查最容易住院的ad，将定义成对疾病并发的总体模式。统计上确定的过剩和赤字并发模式都将提供信息。免疫、内分泌和产前事件将为解释发病年龄、发病顺序、性别以及传染病影响与T1D并发的关系提供功能背景。

DESCRIPTION (provided by applicant): This research explores the etiology of Type 1 Diabetes (T1D) through study of patterns of disease concurrence, especially with other autoimmune diseases (AD). Disease concurrence--the occurrence in an individual of two or more diseases--is a prominent feature of autoimmunity, and of T1D in particular. In preliminary studies we establish the methods to obtain the first true population based disease concurrence prevalence rates, and of quantifying the extent of disease concurrence patterns, long thought to be a characteristic feature of autoimmune disease. The relationships among ADs actually constitute a constellation of interrelated diseases, and are thought to reflect common underlying causative factors, due to the interplay of genetic environmental (including infectious agents), sex-related and early life conditional factors. Clarification of the relative importance of these factors for T1D can be revealed and quantified by the study of AD concurrence. Statistical analysis of the national population-based Swedish health data bases, including two diabetes registries, the hospitalization discharge registry, the birth registry and the cancer registry, will be used to uncover similarities and contrast in patterns of disease concurrence in T1D. Linkage of individuals across registries will permit an assessment of T1D disease concurrence and influential cofactors such as birth weight. By examining the ADs most subject to hospitalization, overall patterns of pairwise disease concurrence will be defined. Both statistically established excess and deficit concurrence patterns will be informative. Immune, endocrine and prenatal events will supply the functional background for interpreting age of onset, order of disease onset, gender and the relationship of infectious disease effects relative to T1D concurrence.