Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
Pediatr Diabetes. 2011 Mar;12(2):91-4. doi: 10.1111/j.1399-5448.2010.00669.x. Epub 2010 Sep 6.
Maternal age at birth, birth weight, and cesarean section has been associated with a weak but significant increase in risk of type 1 diabetes. The objective was to assess whether the relative risk for type 1 diabetes conferred by established susceptibility loci human leukocyte antigen (HLA)-DQ, INS, and PTPN22 differed depending on these perinatal factors.
We employed a case-control study with 456 cases of type 1 diabetes diagnosed before 15 yr of age and 1377 population-based control children. HLA genotypes were divided into high to moderate risk (DQ8/DQ2, DQ8/DQ8, DQ8/X, DQ2/DQ2) vs. all other genotypes. Case-only analysis using logistic regression was used to test for significant interaction.
There was no significant difference in the relative risks conferred by HLA-DQ, INS, or PTPN22 by maternal age, birth weight, or mode of delivery, except the relative risk conferred by PTPN22 which was 2.11 [95% confidence interval (CI): 1.64-2.72] for those born vaginally and 0.99 (95% CI: 0.50-1.99) for those born by cesarean section [p(interaction) = 0.028].
The relative risks conferred by the three established susceptibility genes investigated here were independent of the perinatal factors, apart from a possible interaction between PTPN22 and mode of delivery.
母亲的分娩年龄、出生体重和剖宫产与 1 型糖尿病风险的微弱但显著增加有关。本研究旨在评估已确定的易感性基因 HLA-DQ、INS 和 PTPN22 赋予 1 型糖尿病的相对风险是否因这些围产期因素而有所不同。
我们采用了一项病例对照研究，共纳入 456 例 15 岁以下确诊的 1 型糖尿病患者和 1377 名基于人群的对照儿童。HLA 基因型分为高至中度风险（DQ8/DQ2、DQ8/DQ8、DQ8/X、DQ2/DQ2）与所有其他基因型。使用逻辑回归进行病例-only 分析以检验是否存在显著的交互作用。
除 PTPN22 外，HLA-DQ、INS 或 PTPN22 赋予的相对风险与母亲年龄、出生体重或分娩方式均无显著差异，PTPN22 赋予的相对风险对于经阴道分娩的个体为 2.11（95%置信区间：1.64-2.72），而对于剖宫产分娩的个体为 0.99（95%置信区间：0.50-1.99）[p（交互作用）=0.028]。
除 PTPN22 与分娩方式之间可能存在交互作用外，本研究中所研究的三个已确定的易感性基因赋予的相对风险与围产期因素无关。
