儿童1型糖尿病生命早期相关影响因素的病例对照研究

刘合作; 孙琦; 魏薇; 翟玲玲; 白英龙; 贾丽红

doi:10.16835/j.cnki.1000-9817.2021.01.031

儿童1型糖尿病生命早期相关影响因素的病例对照研究

doi: 10.16835/j.cnki.1000-9817.2021.01.031

中国医科大学公共卫生学院儿少卫生与妇幼保健学教研室，辽宁沈阳 110122

基金项目:

国家自然科学基金项目 81673190

详细信息

作者简介:
刘合作(1989-)，男，湖北黄石人，在读硕士，主要研究方向为儿童糖尿病的影响因素

通讯作者:
贾丽红，E-mail: lhjia@cmu.edu.cn

中图分类号: R 446 R 587.1 R 179
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- 被引次数: 0
出版历程
- 收稿日期: 2020-05-07
- 修回日期: 2020-06-30
- 网络出版日期: 2021-04-01
- 刊出日期: 2021-01-25

Case-control study of early life-related risk factors associated with type 1 diabetes mellitus in children

Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang(110122), China

摘要

摘要: 目的探讨儿童1型糖尿病(T1DM)发生的影响因素，为有针对性采取防治措施提供参考。方法采用病例对照研究，选取沈阳市某医院106例确诊为T1DM的患儿为病例组，同期按照年龄、性别、居住地区1：1匹配的原则，选取106名健康儿童作为对照组，对两组生命早期可能影响T1DM发生发展的因素进行问卷调查。结果 106例T1DM患儿平均确诊年龄为(8.02±3.49)岁; 女童占60.4%，男童占39.6%。多因素Logistic回归分析显示，家庭经济好、父亲文化程度高与T1DM的发生呈负相关; 而家庭成员吸烟(OR=2.51, 95%CI=1.19~5.29)、有糖尿病家族史(OR=2.56, 95%CI=1.18~5.55)、母亲肥胖(OR=5.42, 95%CI=2.49~11.83)和孕期感染(OR=3.45, 95%CI=1.04~11.46)与T1DM发生呈正相关(P值均 < 0.05)。结论儿童T1DM的发生受遗传、母孕期健康及家庭经济等多因素的影响，从生命早期开始预防儿童T1DM的发生具有重要意义。
- 糖尿病，1型 /
- 病例对照研究 /
- 回归分析 /
- 儿童
Abstract: Objective To investigate the affecting factors of type 1 diabetes mellitus(T1DM) in children, and to provide reference for the prevention and treatment measures in the future. Methods A case-control study was carried out among 106 children diagnosed with T1DM in a hospital in Shenyang. At the same time, 106 healthy children were selected as the control group by 1∶1 matching of age, gender and living area. The early life-related factors that may affect the development of T1DM in two groups were investigated by questionnaire. Results The average age of diagnosis in 106 cases with T1DM was(8.02±3.49) years, girls accounted for 60.4% and boys 39.6%. Multi-factor Logistic regression analysis showed that high family socioeconomic status and higher education of fathers were associated with lower odds of development of T1DM. Family member smoking(OR=2.51, 95%CI=1.19-5.29), family history of diabetes(OR=2.56, 95%CI=1.18-5.55), maternal obesity(OR=5.42, 95%CI=2.49-11.83) and infection during pregnancy(OR=3.45, 95%CI=1.04-11.46) were associated with higher risk of T1DM(P < 0.05). Conclusion The occurrence of T1DM in children is affected by many factors including heredity, maternal health during pregnancy and family economy, highlighting the importance of early life prevention of T1DM.
- Diabetes mellitus, tpye 1 /
- Case-control studies /
- Regression analysis /
- Child

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表 1 不同影响因素下两组儿童分布情况比较

Table 1. Comparison of the distribution of two groups children under different influencing factors

变量	选项	病例组 (n=106)	对照组 (n=106)	χ²值	P值
家庭经济	好	7(6.7)	26(24.8)	38.03	< 0.01
	一般	57(54.8)	73(69.5)
	差	40(38.5)	6(5.7)
家庭成员吸烟	是	67(63.2)	49(46.2)	6.17	0.01
	否	39(36.8)	57(53.8)
糖尿病家族史	是	47(44.3)	26(24.5)	9.21	< 0.01
	否	59(55.7)	80(75.5)
父亲肥胖	否	68(64.2)	60(56.6)	1.26	0.26
	是	38(35.8)	46(43.4)
母亲肥胖	否	52(49.1)	90(84.9)	30.79	< 0.01
	是	54(50.9)	16(15.1)
父亲文化程度	大专以上	25(23.8)	55(51.9)	45.33	< 0.01
	高中	21(20.0)	38(35.8)
	初中及以下	59(56.2)	13(12.3)
母亲文化程度	大专以上	29(27.6)	65(61.3)	35.83	< 0.01
	高中	24(22.9)	27(25.5)
	初中及以下	52(49.5)	14(13.2)
孕期补充维生素D	是	41(38.7)	68(64.2)	13.77	< 0.01
	否	65(61.3)	38(35.8)
孕期母亲感染	是	17(16.0)	6(5.7)	5.90	0.02
	否	89(84.0)	100(94.3)
出生体重/kg	<2.5	4(3.8)	4(3.8)	0.12	0.94
	2.5~ <4.0	80(75.5)	82(77.4)
	≥4.0	22(20.8)	20(18.9)
分娩方式	顺产	40(37.7)	47(44.3)	0.95	0.33
	剖腹产	66(62.3)	59(55.7)
出生后0~4月母乳	是	76(71.7)	62(58.5)	4.07	0.04
喂养	否	30(28.3)	44(41.5)
目前儿童BMI	非超重肥胖	98(92.5)	91(85.8)	2.39	0.12
	超重肥胖	8(7.5)	15(14.2)
注： ()内数字为构成比%; 表中数据存在缺失值。

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表 2 儿童1型糖尿病影响因素的多因素Logistic回归分析(n=212)

Table 2. Analysis of multivariate Logistic regression of the influencing factors of type 1 diabetes mellitus in children (n=212)

自变量	β值	标准误	Wald χ²值	P值	OR值(OR值95%CI)
家庭经济
一般	-1.50	0.61	6.06	0.01	0.22(0.06~0.73)
好	-2.71	0.78	11.91	0.00	0.06(0.01~0.31)
家庭成员吸烟	0.92	0.38	5.89	0.02	2.51(1.19~5.29)
糖尿病家族史	0.94	0.39	5.68	0.02	2.56(1.18~5.55)
母亲肥胖	1.69	0.39	18.10	< 0.01	5.42(2.49~11.83)
父亲文化程度
高中	-0.69	0.65	1.14	0.29	0.49(0.13~1.78)
大专及以上	-1.74	0.58	3.92	< 0.05	0.35(0.12~0.98)
母亲文化程度
高中	-0.97	0.65	2.20	0.14	0.37(0.10~1.36)
大专及以上	-0.38	0.63	0.36	0.55	0.68(0.19~2.35)
孕期补充维生素D	-0.50	0.37	1.80	0.18	0.60(0.28~1.26)
孕期母亲感染	1.24	0.61	4.10	0.04	3.45(1.04~11.46)
出生后0~4月母乳喂养	0.18	0.40	0.21	0.65	1.20(0.54~2.63)

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