Begue R E, Mirza A, Compton T, Gomez R, Vargas A
Department of Pediatrics, Louisiana State University and Children's Hospital, New Orleans, Louisiana 70118, USA.
Pediatrics. 1999 Jun;103(6):e83. doi: 10.1542/peds.103.6.e83.
Helicobacter pylori induces gastric inflammation and the the production of cytokines in infected individuals. Theoretically, this increased production of cytokines could be deleterious for the control of the glycemia of patients with diabetes. This study aimed to describe the insulin requirement among patients with type 1 diabetes and H pylori infection compared with uninfected counterparts.
Cross-sectional design. Demographic information (age, gender, race, annual family income, and number of individuals per room in the household) and clinical information (age at diagnosis of diabetes, duration of illness, weight, height, compliance with clinical appointments, daily insulin units per kilogram of body weight [IU/kg/d], and glycosylated hemoglobin A level) was obtained from children and adolescents with diagnosis of type 1 diabetes mellitus who were seen at Children's Hospital in New Orleans. A total of 2 mL of blood was also collected and sera were tested for H pylori-specific immunoglobulin G antibodies using an enzyme immunoassay. The daily insulin requirement among infected and uninfected children was compared, and the effect of other variables was evaluated with multiple linear regression.
Of the 71 subjects who were evaluated (median age: 11 years), 11 (15.5%) were found to be infected. H pylori infection was more frequent among subjects who were older, who had a lower family income, and who were black. Infected children were found to require more insulin (1.2 vs 0.9 IU/Kg/d) and their glycosylated hemoglobin A level was higher (14.9 vs 11.8) than the level found in uninfected subjects. Multiple linear regression analysis identified H pylori infection duration of illness, race (black), body mass index, and gender (female), to be associated independently with increased daily insulin requirement (IU/kg/d).
n our study population, children with type 1 diabetes and H pylori infection had an increased daily insulin requirement compared with the requirement of their uninfected peers. The reason for this association requires additional investigation.
幽门螺杆菌可诱发感染个体的胃部炎症并促使细胞因子产生。从理论上讲，这种细胞因子产生量的增加可能对糖尿病患者的血糖控制有害。本研究旨在描述1型糖尿病合并幽门螺杆菌感染患者与未感染患者相比的胰岛素需求量。
采用横断面设计。从新奥尔良儿童医院确诊为1型糖尿病的儿童和青少年中获取人口统计学信息（年龄、性别、种族、家庭年收入以及家庭人均居住面积）和临床信息（糖尿病诊断年龄、病程、体重、身高、临床预约依从性、每日每千克体重胰岛素用量[IU/kg/d]以及糖化血红蛋白A水平）。还采集了2毫升血液，采用酶免疫分析法检测血清中幽门螺杆菌特异性免疫球蛋白G抗体。比较感染和未感染儿童的每日胰岛素需求量，并通过多元线性回归评估其他变量的影响。
在评估的71名受试者（中位年龄：11岁）中，发现11名（15.5%）感染。幽门螺杆菌感染在年龄较大、家庭收入较低以及黑人受试者中更为常见。发现感染儿童比未感染受试者需要更多胰岛素（1.2 vs 0.9 IU/Kg/d），且其糖化血红蛋白A水平更高（14.9 vs 11.8）。多元线性回归分析确定幽门螺杆菌感染、病程、种族（黑人）、体重指数和性别（女性）与每日胰岛素需求量增加（IU/kg/d）独立相关。
在我们的研究人群中，1型糖尿病合并幽门螺杆菌感染的儿童与未感染的同龄人相比，每日胰岛素需求量增加。这种关联的原因需要进一步研究。
