Diabetologia:早产与1型和2型糖尿病风险?

2020-04-12 MedSci原创 MedSci原创

继往研究表明,早产(孕周小于37周)与生命早期的胰岛素抵抗有关。然而,目前仍没有大规模的基于人群的研究对1型和2型糖尿病的风险以及从儿童到成年的潜在性别差异开展过研究。

继往研究表明,早产(孕周小于37周)与生命早期的胰岛素抵抗有关。然而,目前仍没有大规模的基于人群的研究对1型和2型糖尿病的风险以及从儿童到成年的潜在性别差异开展过研究。临床医生越来越多地遇到早产成年人,因此,需要了解他们的长期风险。我们假设早产与成年期1型和2型糖尿病风险增加有关。

一项全国队列研究对1973年至2014年在瑞典出生的4193,069名独生子女进行了跟踪调查,对从全国诊断和药房数据中确定的1型和2型糖尿病患者一直随访到2015年底(最高年龄43岁;随访结束时的中位年龄为22.5岁)。采用Cox回归校正潜在的混杂因素,而同源分析则评估了共同的家族性(遗传和/或环境)因素的影响。

在9 230万人年的随访中,分别有27 512人(0.7%)和5525人(0.1%)被确认为1型和2型糖尿病。出生时的妊娠年龄与1型和2型糖尿病风险成反比。与早产儿相关的1型和2型糖尿病在小于18岁时的调整后HR分别为1.21(95%CI,1.14,1.28)和1.26(95%CI,1.01,1.58),18-43岁时与足月分娩相比,调整后HR分别为1.24(95%CI,1.13,1.37)和1.49(95%CI,1.31,1.68)。早产与2型(但不是1型)糖尿病之间的关联在女性中更强(例如,在18-43岁时,女性:调整后的HR,1.75;95% CI,1.47,2.09;男性:1.28;95% CI,1.08,1.53;对于加法和乘法相互作用,P <0.01)。这些关联仅部分可由家族中的共同遗传或环境因素解释。

研究结果表明,在这个大型的全国性队列中,早产儿与1型和2型糖尿病的风险从儿童期到成年早期到中期的风险增加有关。早产儿和成人可能需要对糖尿病进行早期预防评估和长期监测。

原始出处:

Casey Crump,Jan Sundquist & Kristina Sundquist,Preterm birth and risk of type 1 and type 2 diabetes: a national cohort study

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