Young T Kue, Martens Patricia J, Taback Shayne P, Sellers Elizabeth A C, Dean Heather J, Cheang Mary, Flett Bertha
Department of Community Health Sciences, University of Manitoba, 750 Bannatyne Ave, Winnipeg, Manitoba, Canada R3E 0W3.
Arch Pediatr Adolesc Med. 2002 Jul;156(7):651-5. doi: 10.1001/archpedi.156.7.651.
Type 2 diabetes mellitus is increasingly being observed among children and youth, including the Native population of Canada. Only one study has investigated prenatal and early infancy risk factors for the disease.
A case-control study was conducted; 46 patients younger than 18 years were recruited from the only clinical center for the treatment of diabetes serving the province of Manitoba, and 92 age- and sex-matched controls were recruited from a pediatric ambulatory clinic serving a large Native population in Winnipeg, Manitoba. Information on exposure to prenatal and early infancy risk factors was obtained through questionnaires administered by a Native nurse-interviewer.
Multiple logistic regression modeling identified preexisting diabetes (odds ratio [OR], 14.4; 95% confidence interval [CI], 2.86-72.5), gestational diabetes (OR, 4.40; 95% CI, 1.38-14.1), and breastfeeding longer than 12 months (OR, 0.24; 95% CI, 0.13-0.99) as significant independent predictors of diabetic status. Other factors, such as low (<2500 g) and high (>4000 g) birth weight and maternal obesity, were also associated with diabetes in our population, but the elevated risks were not statistically significant.
Breastfeeding reduces the risk of type 2 diabetes among Native Canadian children and should be promoted as a potential intervention to control the disease.
儿童和青少年中2型糖尿病的发病率日益增加，包括加拿大原住民。仅有一项研究调查了该疾病的产前和婴儿早期风险因素。
开展了一项病例对照研究；从曼尼托巴省唯一的糖尿病治疗临床中心招募了46名18岁以下的患者，并从曼尼托巴省温尼伯市为大量原住民服务的儿科门诊招募了92名年龄和性别匹配的对照。通过一名原住民护士访谈员发放的问卷获取有关产前和婴儿早期风险因素暴露的信息。
多因素logistic回归模型确定，既往糖尿病（比值比[OR]，14.4；95%置信区间[CI]，2.86 - 72.5）、妊娠期糖尿病（OR，4.40；95% CI，1.38 - 14.1）以及母乳喂养超过12个月（OR，0.24；95% CI，0.13 - 0.99）是糖尿病状态的显著独立预测因素。其他因素，如低出生体重（<2500 g）和高出生体重（>4000 g）以及母亲肥胖，在我们的人群中也与糖尿病相关，但风险升高无统计学意义。
母乳喂养可降低加拿大原住民儿童患2型糖尿病的风险，应作为控制该疾病的一种潜在干预措施加以推广。
