Department of General Paediatrics, Neonatology and Paediatric Cardiology, University Children's Hospital Düsseldorf, Düsseldorf, Germany.
Horm Res Paediatr. 2013;79(6):368-72. doi: 10.1159/000351708. Epub 2013 Jun 19.
BACKGROUND/AIMS: Lipoatrophy (LA) is a rare, possibly under-recognised side effect of insulin treatment of unclear aetiology. The aim of this study was to describe the characteristics of patients with type 1 diabetes (T1D) who have LA and to explore the relationship between LA and other autoimmune diseases based on the hypothesis that additional autoimmune phenomena are more prevalent in T1D patients with LA.
This was a cross-sectional observational study of T1D patients with LA in comparison to T1D patients without LA who are registered with the Diabetes Patienten-Verlaufsdokumentationssystem database of 241,650 patients in Germany and Austria.
Hashimoto's thyroiditis and coeliac disease were more prevalent in patients with LA (p < 0.001 for both). LA was associated with an increased risk of Hashimoto's thyroiditis and coeliac disease in female patients [odds ratio (OR) 2.5, p = 0.003, and OR 3.1, p = 0.02, respectively]. This relationship persisted after adjustment for current age, duration of diabetes and calendar year of treatment (OR 2.7, p = 0.002, and OR 3.5, p = 0.01, respectively).
These findings support the hypothesis that an immune complex-mediated inflammatory process may be important in the development of LA.
背景/目的：脂肪萎缩（LA）是一种罕见的、可能未被识别的胰岛素治疗的副作用，其病因尚不清楚。本研究的目的是描述 1 型糖尿病（T1D）患者中出现 LA 的患者的特征，并基于以下假设（即 LA 患者中更常见其他自身免疫现象），探讨 LA 与其他自身免疫性疾病之间的关系，即免疫复合物介导的炎症过程可能在 LA 的发生中起重要作用。
这是一项横断面观察性研究，比较了德国和奥地利的 241650 名患者的 Diabetes Patienten-Verlaufsdokumentationssystem 数据库中患有 LA 的 T1D 患者与未患 LA 的 T1D 患者。
桥本甲状腺炎和乳糜泻在 LA 患者中更为常见（两者均 p < 0.001）。LA 与女性患者桥本甲状腺炎和乳糜泻的风险增加相关[比值比（OR）2.5，p = 0.003 和 OR 3.1，p = 0.02]。调整当前年龄、糖尿病病程和治疗年份后，这种相关性仍然存在（OR 2.7，p = 0.002 和 OR 3.5，p = 0.01）。
这些发现支持以下假设，即免疫复合物介导的炎症过程可能在 LA 的发生中起重要作用。
