O'Connell M A, Donath S, Cameron F J
Department of Endocrinology and Diabetes, Royal Children's Hospital and Murdoch Children's Research Institute, Melbourne, Australia.
Diabet Med. 2007 Aug;24(8):920-3. doi: 10.1111/j.1464-5491.2007.02203.x. Epub 2007 May 29.
The Accelerator Hypothesis postulates that the apparent increase in incidence of Type 1 diabetes mellitus (T1DM) is related to an acceleration of disease onset by weight-related insulin resistance. Our diabetes clinic has experienced a major recent increase in newly diagnosed diabetes. The Accelerator Hypothesis predicts that this increase should be associated with younger age and increased body mass at diagnosis, with youngest children having the highest body mass index (BMI).
To test the Accelerator Hypothesis in the context of the major increase in T1DM at our centre.
Data from all young people diagnosed with T1DM between 1992 and 2003 were reviewed. Height and weight measurements from initial outpatient review were used to calculate BMI.
The mean increase in BMI standard deviation score (SDS) is 0.03 per year (P = 0.01). Age at diagnosis has also increased by a mean of 0.11 years annually (P = 0.003). There was no association between BMI SDS and age at diagnosis (P = 0.7). A significant difference in BMI SDS between age-banded subgroups was evident (P = 0.04); however, youngest children had the lowest SDS.
Our results do not support increased body mass as an accelerator of diabetes presentation.
加速假说假定1型糖尿病（T1DM）发病率的明显上升与体重相关的胰岛素抵抗导致疾病发病加速有关。我们的糖尿病诊所最近新诊断出的糖尿病患者大幅增加。加速假说预测，这种增加应与诊断时年龄较小和体重增加有关，年龄最小的儿童体重指数（BMI）最高。
在我们中心T1DM大幅增加的背景下检验加速假说。
回顾了1992年至2003年间所有被诊断为T1DM的年轻人的数据。使用初次门诊复查时的身高和体重测量值来计算BMI。
BMI标准差评分（SDS）的年平均增加为0.03（P = 0.01）。诊断时的年龄每年也平均增加0.11岁（P = 0.003）。BMI SDS与诊断时的年龄之间无关联（P = 0.7）。年龄分组亚组之间的BMI SDS存在显著差异（P = 0.04）；然而，年龄最小的儿童SDS最低。
我们的结果不支持体重增加是糖尿病表现的加速因素这一观点。
