Cooper Matthew N, de Bock Martin I, Carter Kim W, de Klerk Nicholas H, Jones Timothy W, Davis Elizabeth A
Telethon Kids Institute, The University of Western Australia, Perth, Australia.
Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia.
J Diabetes Complications. 2017 May;31(5):843-849. doi: 10.1016/j.jdiacomp.2016.11.022. Epub 2017 Jan 20.
To determine the incidence of hospitalisations and risk factors for vascular complications experienced during early adulthood in patients with childhood onset type 1 diabetes.
A population-based childhood onset type 1 diabetes cohort was identified from a statewide register (1992-2012). Data linkage was used to identify a matched comparison cohort. Hospital admissions data were extracted to follow up both cohorts into early adulthood (1975-2012).
The type 1 diabetes cohort (n=1316) had a mean age of diagnosis of 9.5years, 49.5% were women and mean age at the end of follow-up was 26.3years (range 18-38). Within the type 1 diabetes cohort 32 (2.4%) were hospitalised with a vascular complication during early adulthood. Poor glycaemic control during paediatric management was associated with a significant increase in risk for ophthalmic complication with 19.4% (n=12/62) of those with a mean HbA1c >12% (108mmol/mol) diagnosed compared to 0.72% (n=5/696) of those with mean HbA1c <9% (75mmol/mol), adjusted hazard ratio 8.4 (95% CI 2.0, 34.7).
Severe vascular complications requiring hospital admission continue to be observed during early adulthood. Both women and those with poor glycaemic control are at increased risk of requiring a hospital admission for these complications during early adulthood.
确定儿童期发病的1型糖尿病患者在成年早期住院的发生率及血管并发症的危险因素。
从全州范围的登记册(1992 - 2012年)中确定一个基于人群的儿童期发病的1型糖尿病队列。采用数据链接来确定一个匹配的对照队列。提取医院入院数据以对两个队列进行随访直至成年早期(1975 - 2012年)。
1型糖尿病队列(n = 1316)的平均诊断年龄为9.5岁,49.5%为女性,随访结束时的平均年龄为26.3岁(范围18 - 38岁)。在1型糖尿病队列中,32例(2.4%)在成年早期因血管并发症住院。儿童期管理期间血糖控制不佳与眼部并发症风险显著增加相关,平均糖化血红蛋白>12%(108mmol/mol)的患者中有19.4%(n = 12/62)被诊断出患有眼部并发症,而平均糖化血红蛋白<9%(75mmol/mol)的患者中这一比例为0.72%(n = 5/696),调整后的风险比为8.4(95%CI 2.0, 34.7)。
在成年早期仍可观察到需要住院治疗的严重血管并发症。女性以及血糖控制不佳的患者在成年早期因这些并发症需要住院治疗的风险增加。