Department of Paediatrics and Neonatology, Saarland University Hospital, Kirrberger Str. 1, Geb. 9, 66421 Homburg/Saar, Germany.
Diabetologia. 2010 Jun;53(6):1070-5. doi: 10.1007/s00125-010-1686-z. Epub 2010 Feb 26.
AIMS/HYPOTHESIS: Intellectual impairment in individuals with Down's syndrome and diabetes mellitus potentially limits the quality of diabetic control. In addition, these patients are at risk of having immunological abnormalities. The present study compared metabolic status and concomitant diseases in young (<20 years old) Down's syndrome patients with diabetes vs young type 1 diabetic patients.
The Diabetes-Patienten-Verlaufsdaten is a longitudinal follow-up database, which collects data from 298 German and Austrian diabetes centres. Data available on diabetic patients aged <20 years were analysed statistically.
We compared data for 159 Down's syndrome patients with diabetes and 41,983 type 1 diabetic patients. The former used less insulin, but showed better glycaemic control (HbA1c). Diabetes onset during the first 3 years of life occurred in 18.9% of Down's syndrome patients with diabetes and in 6.4% of type 1 diabetic patients. Antibody titres indicative of coeliac disease and thyroid peroxidase antibodies were more frequent in Down's syndrome patients with diabetes. No significant differences were found regarding the beta cell autoantibodies studied.
CONCLUSIONS/INTERPRETATION: The age-of-onset distribution showed a shift towards younger ages and was bimodal in the Down's syndrome group. The better metabolic control found, despite intellectual impairment, in young Down's syndrome patients with diabetes cannot be conclusively explained by our data, but is likely to be due to a less complex lifestyle. Our data provide further confirmation that coeliac and thyroid antibodies are more prevalent in Down's syndrome. The presence of beta cell autoantibodies supports an autoimmune cause of diabetes in some children with Down's syndrome.
目的/假设：唐氏综合征患者的智力障碍可能会限制其糖尿病控制的质量。此外，这些患者还存在免疫异常的风险。本研究比较了年轻（<20 岁）唐氏综合征合并糖尿病患者与年轻 1 型糖尿病患者的代谢状况和合并症。
糖尿病患者病程数据库（Diabetes-Patienten-Verlaufsdaten）是一个纵向随访数据库，它收集了来自 298 个德国和奥地利糖尿病中心的数据。对年龄<20 岁的糖尿病患者的数据进行了统计学分析。
我们比较了 159 名唐氏综合征合并糖尿病患者和 41983 名 1 型糖尿病患者的数据。前者使用的胰岛素较少，但血糖控制（HbA1c）更好。18.9%的唐氏综合征合并糖尿病患者在生命的头 3 年内发病，而 1 型糖尿病患者的这一比例为 6.4%。唐氏综合征合并糖尿病患者的抗麦胶蛋白抗体和甲状腺过氧化物酶抗体的抗体滴度更为常见。在所研究的β细胞自身抗体方面，未发现显著差异。
结论/解释：发病年龄分布在唐氏综合征组中呈现出向更年轻年龄的转移，且呈双峰分布。尽管存在智力障碍，但年轻的唐氏综合征合并糖尿病患者的代谢控制较好，这一现象不能用我们的数据来明确解释，但可能与他们相对简单的生活方式有关。我们的数据进一步证实了在唐氏综合征患者中，抗麦胶蛋白抗体和甲状腺抗体更为常见。β细胞自身抗体的存在支持某些唐氏综合征儿童的糖尿病具有自身免疫性病因。
