Malcova Hana, Sumnik Zdenek, Drevinek Pavel, Venhacova Jitrenka, Lebl Jan, Cinek Ondrej
Department of Paediatrics, Motol University Hospital, Charles University, V Uvalu 84, 150 06 rague 5, Czech Republic.
Eur J Pediatr. 2006 Feb;165(2):114-9. doi: 10.1007/s00431-005-0008-9. Epub 2005 Oct 7.
There are indications that the effect of environmental factors on the risk of type 1 diabetes mellitus (T1DM) is increasing over time. This can be documented by the rapid increase of T1DM incidence in genetically stable populations. Our aim was to study an association of T1DM with the variable factors of the perinatal period and of early infancy, using data from children born over a period of changing exposure to some of the studied factors. A case-control dataset was analysed, consisting of 868 diabetic children and 1,466 anonymous controls, mostly schoolmates of the children with T1DM. The data were collected using structured questionnaires completed by parents. After performing univariate analyses, the associations were analysed using multiple logistic regression adjusted for potential confounders, including the year of birth. The risk of T1DM decreased with increasing duration of breast-feeding, while no breast-feeding was associated with an increased T1DM risk, OR=1.93 [95% CI: 1.33-2.80], breast-feeding for more than 12 months was protective, OR=0.42 [95% CI: 0.22-0.81], both being relative to the reference category of breast-feeding for 1-3 months. A short duration of day-care attendance (none or less than 1 year) was weakly associated with the risk of T1DM, OR=1.65 [95% CI: 1.05-2.62]. No association was detected between T1DM and signs of prenatal infections, perinatal stress factors, birth size and weight, indicators of crowding or the presence of a domestic pet in the household. Short breast-feeding period and short attendance to day care is associated with the risk of T1DM in Czech children.
有迹象表明，环境因素对1型糖尿病（T1DM）风险的影响正随着时间的推移而增加。这一点可通过基因稳定人群中T1DM发病率的快速上升得到证明。我们的目的是利用在一段时间内某些研究因素暴露情况发生变化时出生的儿童的数据，研究T1DM与围生期和婴儿早期可变因素之间的关联。分析了一个病例对照数据集，该数据集由868名糖尿病儿童和1466名匿名对照组成，大多数是T1DM儿童的同学。数据通过父母填写的结构化问卷收集。在进行单因素分析后，使用针对潜在混杂因素（包括出生年份）进行调整的多因素逻辑回归分析这些关联。T1DM风险随着母乳喂养时间的延长而降低，而未进行母乳喂养与T1DM风险增加相关，OR = 1.93 [95% CI：1.33 - 2.80]，母乳喂养超过12个月具有保护作用，OR = 0.42 [95% CI：0.22 - 0.81]，两者均相对于母乳喂养1 - 3个月的参考类别。日托时间短（无或少于1年）与T1DM风险弱相关，OR = 1.65 [95% CI：1.05 - 2.62]。未发现T1DM与产前感染迹象、围生期应激因素、出生大小和体重、拥挤指标或家中是否有宠物之间存在关联。母乳喂养时间短和日托时间短与捷克儿童患T1DM的风险相关。
