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科威特1型糖尿病的早发:独特的临床、代谢和免疫学特征。

Early Onset of Type 1 Diabetes in Kuwait: Distinct Clinical, Metabolic, and Immunological Characteristics.

作者信息

Al-Abdulrazzaq Dalia, Qabazard Mariam, Al-Jasser Fahad, Al-Anizi Ayed, Al-Basari Iman, Mandani Fawziya, Al-Kandari Hessa

机构信息

Department of Pediatrics, College of Medicine, Kuwait University, Kuwait City, Kuwait.

Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait.

出版信息

Med Princ Pract. 2024;33(6):555-561. doi: 10.1159/000540705. Epub 2024 Aug 2.

Abstract

OBJECTIVE

Exploring early-onset diabetes in terms of describing characteristics at time of diagnosis might aid in a better understanding of etiology and may have implications on management and prevention. The aim of this study was to investigate the prevalence of early-onset type 1 diabetes (T1D) in Kuwait as well as describe their baseline clinical, biochemical, and immunological characteristics.

METHODS

Medical records of children newly diagnosed with T1D and registered in the Childhood-Onset Diabetes electronic Registry (CODeR) in Kuwait between 2017 and 2022 were reviewed. Early-onset T1D was defined as diagnosis at age younger than 6 years.

RESULTS

2,051 children were registered with new-onset T1D between 2017 and 2022, of which 657 (32.0%) were diagnosed at early onset. There has been a trend of slight increase in the percentage of early-onset T1D after 2020 (15.2%) with a prevalence of 18.4% and 20.2% in 2021 and 2022, respectively (p = 0.056). Age at onset was inversely related to admission to the pediatric intensive care unit (OR = 0.90, 95% CI: 0.85, 0.95, p < 0.0001) and was directly related to positive celiac autoimmunity (p = 0.022), higher hemoglobin A1C (p < 0.0001), and C-peptide levels (p < 0.0001). However, age at onset of T1D was inversely related to the higher vitamin D levels (p < 0.0001).

CONCLUSION

These findings reinforce the need for increased attention to be given to study the development of T1D in children of younger age. This in turn will support special management and prevention measures targeted toward this vulnerable age group.

摘要

目的

从描述诊断时的特征方面探索早发性糖尿病,可能有助于更好地理解病因,并可能对管理和预防产生影响。本研究的目的是调查科威特早发性1型糖尿病(T1D)的患病率,并描述其基线临床、生化和免疫特征。

方法

回顾了2017年至2022年期间在科威特儿童期糖尿病电子登记处(CODeR)登记的新诊断为T1D的儿童的病历。早发性T1D定义为6岁以下诊断。

结果

2017年至2022年期间,有2051名儿童登记新发T1D,其中657名(32.0%)为早发性诊断。2020年后早发性T1D的百分比有轻微上升趋势(15.2%),2021年和2022年的患病率分别为18.4%和20.2%(p = 0.056)。发病年龄与入住儿科重症监护病房呈负相关(OR = 0.90,95% CI:0.85,0.95,p < 0.0001),与乳糜泻自身免疫阳性呈正相关(p = 0.022),与较高的糖化血红蛋白(p < 0.0001)和C肽水平呈正相关(p < 0.0001)。然而,T1D的发病年龄与较高的维生素D水平呈负相关(p < 0.0001)。

结论

这些发现强化了需要更多关注研究幼年儿童T1D的发展。这反过来将支持针对这一脆弱年龄组的特殊管理和预防措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6285/11631037/a5395e662aef/mpp-2024-0033-0006-540705_F01.jpg

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