初发的年轻成年人的残余β细胞功能及男女比例高于儿童：意大利都灵省1型糖尿病登记研究，1984 - 2000年

Residual beta-cell function and male/female ratio are higher in incident young adults than in children: the registry of type 1 diabetes of the province of Turin, Italy, 1984-2000.

作者信息

Bruno Graziella, Cerutti Franco, Merletti Franco, Cavallo-Perin Paolo, Gandolfo Enrico, Rivetti Marina, Runzo Cristina, Pinach Silvia, Pagano Gianfranco

机构信息

Department of Internal Medicine, University of Turin, corso Dogliotti 14, I-10126 Turin, Italy.

出版信息

Diabetes Care. 2005 Feb;28(2):312-7. doi: 10.2337/diacare.28.2.312.

DOI:10.2337/diacare.28.2.312

PMID:15677785

Abstract

OBJECTIVE

The hypothesis of age-dependent variations in epidemiologic and clinical features at onset of type 1 diabetes has been assessed in the registry of the province of Turin, Italy.

RESEARCH DESIGN AND METHODS

The study base is the population 0-29 years of age of the province of Turin, in the period from 1984 to 2000. Islet cell antibody (ICA), GAD antibody (GADA), antibodies to protein tyrosine phosphatase (IA2), and C-peptide were measured in subgroups of the cohort.

RESULTS

One thousand fifty-six incident cases have been identified (completeness of ascertainment 98.1%). Rates per 100,000 person-years were similar in males and females in the age-group 0-14 years (10.7, 95% CI 9.5-12.0 vs. 9.8, 8.6-11.1). In the age-group 15-29 years, males had higher risk than females (7.7, 6.9-8.6 vs. 5.3, 4.6-6.1; rate ratio, 1.46, 95% CI 1.23-1.74; P = 0.00002). Fasting plasma C-peptide values (n = 575) were twofold lower in the age-group 0-14 years than in the age-group 15-29 years (0.10 vs. 0.23 nmol/l; P < 0.0001). Frequencies of ICA and IA2 positivities (n = 183) decreased with increasing age, whereas frequency of GADA positivity increased. Idiopathic cases were 12.6% and had higher mean values of fasting (0.28 vs. 0.14 nmol/l; P = 0.043) and stimulated C-peptide (0.59 vs. 0.34 nmol/l; P = 0.05). In logistic regression analyses, subjects with fasting C-peptide values in the upper quartile had higher likelihood of being older (odds ratio 1.20 for year, 95% CI 1.11-1.28), ICA negative (0.26, 0.10-0.70), and female (1.29, 0.48-3.42).

CONCLUSIONS

This study shows 1) sex differences in incidence rates in young adults; 2) better preserved beta-cell function in young adults, in idiopathic cases (12%), and in ICA-negative cases; and 3) lower frequencies of ICA and IA2 positivities and higher frequency of GADA positivity in young adults than in children.

摘要

目的

在意大利都灵省的登记处对1型糖尿病发病时流行病学和临床特征随年龄变化的假说进行了评估。

研究设计与方法

研究对象为1984年至2000年期间都灵省0至29岁的人群。在该队列的亚组中检测了胰岛细胞抗体（ICA）、谷氨酸脱羧酶抗体（GADA）、蛋白酪氨酸磷酸酶抗体（IA2）和C肽。

结果

共识别出1056例新发病例（确诊率98.1%）。0至14岁年龄组中，男性和女性每10万人年的发病率相似（分别为10.7，95%可信区间9.5 - 12.0和9.8，8.6 - 11.1）。在15至29岁年龄组中，男性的发病风险高于女性（分别为7.7，6.9 - 8.6和5.3，4.6 - 6.1；发病率比为1.46，95%可信区间1.23 - 1.74；P = 0.00002）。0至14岁年龄组的空腹血浆C肽值（n = 575）比15至29岁年龄组低两倍（分别为0.10与0.23 nmol/l；P < 0.0001）。ICA和IA2阳性的频率（n = 183）随年龄增加而降低，而GADA阳性的频率增加。特发性病例占12.6%，其空腹（分别为0.28与0.14 nmol/l；P = 0.043）和刺激后C肽（分别为0.59与0.34 nmol/l；P = 0.05）的平均值较高。在逻辑回归分析中，空腹C肽值处于上四分位数的受试者年龄较大（每年的优势比为1.20，95%可信区间1.11 - 1.28）、ICA阴性（0.26，0.10 - 0.70）和女性（1.29，0.48 - 3.42）的可能性更高。