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1型(胰岛素依赖型)糖尿病中胎儿血红蛋白患病率增加。

Increased prevalence of fetal haemoglobin in type 1 (insulin-dependent) diabetes mellitus.

作者信息

Mullis P, Schuler J, Zuppinger K

机构信息

Department of Paediatrics, University of Bern, Switzerland.

出版信息

Diabetologia. 1989 Apr;32(4):227-30. doi: 10.1007/BF00285288.

Abstract

Fetal haemoglobin levels were measured in 106 patients with Type 1 (insulin-dependent) diabetes mellitus during a period of two to three years. In 15 patients (14.1%) increased fetal haemoglobin levels (greater than 0.5%), determined by high pressure liquid chromatography, were found in contrast to 3% in a healthy control group (n: 100) of equal age distribution. In children aged over 6 years, elevated fetal haemoglobin levels were measured in 13 diabetic patients (13.3%) in contrast to none of the control group. There was no correlation between fetal haemoglobin levels and duration of diabetes, diabetic control (glycated haemoglobin) and dosage of insulin (U.kg-1, day-1). The 15 patients had a younger mean age at onset of diabetes (5.6 years) than a sex and age matched control group of diabetic patients without increased fetal haemoglobin levels (7.4 years, p less than 0.05). Longitudinal assessment revealed a significant decline of fetal haemoglobin levels with age (p less than 0.005) but a further increase in fetal haemoglobin levels were found in adolescent patients (n: 2). These data indicate a possible effect of insulin-treatment on delaying transition from fetal to adult haemoglobin synthesis or on reactivation of fetal haemoglobin production.

摘要

在两到三年的时间里,对106例1型(胰岛素依赖型)糖尿病患者的胎儿血红蛋白水平进行了测量。通过高压液相色谱法测定,15例患者(14.1%)的胎儿血红蛋白水平升高(大于0.5%),而年龄分布相同的健康对照组(n = 100)中这一比例为3%。在6岁以上的儿童中,13例糖尿病患者(13.3%)的胎儿血红蛋白水平升高,而对照组中无一例升高。胎儿血红蛋白水平与糖尿病病程、糖尿病控制情况(糖化血红蛋白)及胰岛素剂量(U.kg-1·天-1)之间无相关性。这15例患者糖尿病发病时的平均年龄(5.6岁)低于未出现胎儿血红蛋白水平升高的性别和年龄匹配的糖尿病患者对照组(7.4岁,p < 0.05)。纵向评估显示,胎儿血红蛋白水平随年龄显著下降(p < 0.005),但在青少年患者(n = 2)中发现胎儿血红蛋白水平进一步升高。这些数据表明胰岛素治疗可能对延迟从胎儿血红蛋白合成向成人血红蛋白合成的转变或对胎儿血红蛋白生成的重新激活有影响。

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