体格检查、代谢控制和 1 型糖尿病伴活检证实的乳糜泻患儿和青少年的随访。

Anthropometry, metabolic control, and follow-up in children and adolescents with type 1 diabetes mellitus and biopsy-proven celiac disease.

机构信息

Department of Pediatrics, Medical University of Graz, Graz, Austria.

出版信息

J Pediatr. 2011 Apr;158(4):589-593.e2. doi: 10.1016/j.jpeds.2010.09.050. Epub 2010 Nov 4.

DOI:10.1016/j.jpeds.2010.09.050

PMID:21051047

Abstract

OBJECTIVE

To evaluate the influence of biopsy-proven celiac disease (BPCD) on somatic development and metabolic parameters in children with type 1 diabetes mellitus (T1DM) in a multicenter survey.

STUDY DESIGN

Within the Diabetes Patienten Verlaufsdokumentationssystem-Wiss project, data of 41 951 patients with T1DM, aged <20 years (52% males, mean age 13.9 years; mean duration of diabetes 5.5 years) were collected in 297 centers in Germany and Austria from 1995 to 2009.

RESULTS

The number of BPCD (0.6% in 1995; 1.3% in 2008) has increased over time. Patients with BPCD were significantly younger at diabetes onset (5.9 vs 8.3 years), had a significantly lower weight standard deviation score (SDS); (0.20 vs 0.43) and height SDS (-0.28 vs -0.03) (P < .001, each) compared with patients without celiac disease. No differences were found in hemoglobin A1c or numbers of severe hypoglycemia. In a subgroup of 9805 patients (183 with BPCD) significantly lower height and weight SDS (P < .001) were still found after a 5-year follow-up.

CONCLUSIONS

Screening for celiac disease is important in children with T1DM to prevent persistent growth failure.

摘要

目的

在一项多中心研究中评估活检证实的乳糜泻（BPCD）对 1 型糖尿病（T1DM）患儿体格发育和代谢参数的影响。

研究设计

在糖尿病患者病程记录系统-Wiss 项目中，收集了 1995 年至 2009 年间德国和奥地利 297 个中心的 41951 名年龄<20 岁（52%为男性，平均年龄 13.9 岁；平均糖尿病病程 5.5 年）的 T1DM 患者的数据。

结果

BPCD 的数量（1995 年为 0.6%；2008 年为 1.3%）随时间推移而增加。乳糜泻患者的糖尿病发病年龄明显较小（5.9 岁 vs. 8.3 岁），体重标准差评分（SDS）明显较低（0.20 vs. 0.43），身高 SDS 较低（-0.28 vs. -0.03）（均 P < 0.001）。与无乳糜泻患者相比，血红蛋白 A1c 或严重低血糖的发生次数无差异。在 9805 名患者（BPCD 患者 183 名）的亚组中，仍发现 5 年随访后身高和体重 SDS 明显较低（P < 0.001）。