Malcová H, Sumník Z, Drevínek P, Lebl J, Venhácová J, Vavrinec J, Cinek O
Pediatrická klinika 2. LF UK a FNM, Praha.
Cas Lek Cesk. 2004;143(9):625-9.
Type 1 diabetes mellitus (T1DM) is associated with increased incidence of other autoimmune diseases. The shared genetic background may play a role in the disease pathogenesis. The aim of our study was to assess the prevalence of T1DM and other autoimmune disorders in the first-degree relatives of diabetic children.
Data were retrospectively obtained using structured questionnaires from 868 diabetic children younger than 18 years (434 girls and 434 boys, age 12.5 +/- 4.0, mean +/- SD) and their 2704 relatives. The control group included 1466 non-diabetic schoolmates and friends (796 girls, 670 boys, age 11.9 +/- 4.5) and their 4510 first-degree relatives. In the questionnaire we asked about occurrence of thyroid and celiac disease in cases and controls, and about occurrence of T1DM, thyroid and celiac disease in their first-degree relatives. We observed significantly higher prevalence of T1DM in fathers (4.4% vs. 0.8%), mothers (2.0% vs. 0.5%) and siblings (2.5% vs. 0%) of diabetic children compared to controls. Thyroid disease was found significantly more in diabetic children (10.0% vs. 1.9%) and their siblings (3.1% vs. 1.7%). Prevalence of celiac disease was also higher in diabetic children than in controls (3.2% vs. 0.5%), but it does not differ in their first-degree relatives.
We found significantly higher prevalence of thyroid and celiac disease in T1DM children than in controls. Targeted screening and early detection of thyroid and celiac diseases in T1DM patients are likely to be necessary. We observed an increased prevalence of T1DM and thyroid disease in first-degree relatives of diabetic children, however screening of autoimmune diseases associated with T1DM in the first-degree relatives remain controversial.
1型糖尿病(T1DM)与其他自身免疫性疾病的发病率增加有关。共同的遗传背景可能在疾病发病机制中起作用。我们研究的目的是评估糖尿病儿童一级亲属中T1DM和其他自身免疫性疾病的患病率。
使用结构化问卷回顾性收集了868名18岁以下糖尿病儿童(434名女孩和434名男孩,年龄12.5±4.0,均值±标准差)及其2704名亲属的数据。对照组包括1466名非糖尿病同学和朋友(796名女孩,670名男孩,年龄11.9±4.5)及其4510名一级亲属。在问卷中,我们询问了病例组和对照组中甲状腺疾病和乳糜泻的发生情况,以及他们一级亲属中T1DM、甲状腺疾病和乳糜泻的发生情况。我们观察到,与对照组相比,糖尿病儿童的父亲(4.4%对0.8%)、母亲(2.0%对0.5%)和兄弟姐妹(2.5%对0%)中T1DM的患病率显著更高。糖尿病儿童(10.0%对1.9%)及其兄弟姐妹(3.1%对1.7%)中甲状腺疾病的发现率显著更高。糖尿病儿童中乳糜泻的患病率也高于对照组(3.2%对0.5%)但其一级亲属中的患病率无差异。
我们发现T1DM儿童中甲状腺疾病和乳糜泻的患病率显著高于对照组。对T1DM患者进行甲状腺和乳糜泻疾病的针对性筛查和早期检测可能是必要的。我们观察到糖尿病儿童的一级亲属中T1DM和甲状腺疾病的患病率增加,然而对糖尿病一级亲属中与T1DM相关的自身免疫性疾病进行筛查仍存在争议。