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儿童期发病的1型糖尿病血管并发症的住院治疗——发病时性别和年龄的影响

Hospitalization for vascular complications in childhood onset type 1 diabetes--effects of gender and age at onset.

作者信息

Dahlquist G, Möllsten A, Källén B

机构信息

Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.

出版信息

Acta Paediatr. 2008 Apr;97(4):483-8. doi: 10.1111/j.1651-2227.2008.00680.x. Epub 2008 Feb 27.

DOI:10.1111/j.1651-2227.2008.00680.x
PMID:18307553
Abstract

AIMS

To study the cumulative incidence of hospitalization for severe diabetic vascular complications in childhood onset type 1 diabetes patients with special regards to age at onset and gender.

METHODS

The Swedish Childhood Diabetes Register (SCDR) was linked to the Swedish Hospital Discharge Register up to 31 December 2004. The following diagnoses were traced: diabetic kidney disease, myocardial infarction, stroke, lower limb arterial disease and diabetes with multiple complications. Cox proportional hazards survival method was applied with the following covariates: maternal age, birthweight deviation from gestational week standard, age at onset and gender.

RESULTS

Until 31 December 9974 children had been followed for at least 10 years corresponding to 141 839 person years at risk and 103 (7.3 per 1000 person years) had been hospitalized at least once at the maximum duration of follow-up of 26 years. Diabetic kidney disease was the most common cause of hospitalization and 63 patients had more than one diabetic complication. Female gender (RR=2.02, 95% CI=1.05-3.89) and age at onset of diabetes (RR=1.37, 95% CI=1.20-1.56) were significant risk factors for severe complication.

CONCLUSIONS

Hospitalization for severe diabetic complications at a maximum follow-up of 26 years is rather low in Sweden. There is a higher hospitalization rate among females than among males, and also among patients diagnosed with diabetes after 10 years of age than among patients diagnosed before the age of 10 years.

摘要

目的

研究儿童期发病的1型糖尿病患者严重糖尿病血管并发症的累积住院发生率,并特别关注发病年龄和性别。

方法

将瑞典儿童糖尿病登记处(SCDR)与截至2004年12月31日的瑞典医院出院登记处相链接。追踪以下诊断:糖尿病肾病、心肌梗死、中风、下肢动脉疾病以及伴有多种并发症的糖尿病。采用Cox比例风险生存方法,并纳入以下协变量:母亲年龄、出生体重与孕周标准的偏差、发病年龄和性别。

结果

截至2004年12月31日,9974名儿童至少被随访了10年,相当于141839人年的风险期,在最长26年的随访期间,有103人(每1000人年7.3人)至少住院一次。糖尿病肾病是最常见的住院原因,63名患者有不止一种糖尿病并发症。女性(相对风险率RR = 2.02,95%可信区间CI = 1.05 - 3.89)和糖尿病发病年龄(RR = 1.37,95%CI = 1.20 - 1.56)是严重并发症的显著危险因素。

结论

在瑞典,最长随访26年期间严重糖尿病并发症的住院率相当低。女性的住院率高于男性,10岁后诊断为糖尿病的患者的住院率也高于10岁前诊断的患者。

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