Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Center for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
Diabet Med. 2017 Sep;34(9):1259-1263. doi: 10.1111/dme.13410. Epub 2017 Jul 12.
It has been suggested that experiencing serious life events may promote Type 1 diabetes in children. Studies in adults are lacking, as are studies on the interaction of life events with genetic factors. We aimed to investigate life events and the risk of latent autoimmune diabetes in adults (LADA) and Type 2 diabetes while taking into account HLA genotype.
Analysis was based on 425 incident cases of LADA, 1417 incident cases of Type 2 diabetes and 1702 population-based controls recruited in Sweden between 2010 and 2016. Self-reported information on life events including conflicts, divorce, illness/accidents, death and financial problems experienced during the 5 years preceding diagnosis/index year was used. Odds ratios (ORs) and 95% confidence intervals (95% CI) were calculated by logistic regression and adjusted for age, sex, BMI, family history of diabetes, smoking, physical activity and education.
Overall there was no association between experience of any life event and either LADA (OR 0.86, 95% CI 0.68-1.08) or Type 2 diabetes (OR 1.00, 95% CI 0.83-1.21). The results were similar for individual events as well as in separate analysis of men and women. Similar results were seen in more autoimmune LADA (glutamic acid decarboxylase antibodies > median) [OR (any life event) 0.88, 95% CI 0.64-1.21] and in LADA carriers of the high-risk HLADR4-DQ8 genotype (OR 0.89, 95% CI 0.61-1.29).
Our findings indicate that experience of a serious life event, including the death of a family member, divorce or financial problems, is not associated with an increased risk of LADA, overall or in genetically susceptible individuals.
有人认为，经历严重的生活事件可能会导致儿童患 1 型糖尿病。成人研究较少，且缺乏对生活事件与遗传因素相互作用的研究。我们旨在调查生活事件与成人隐匿性自身免疫性糖尿病（LADA）和 2 型糖尿病的风险，并考虑 HLA 基因型。
该分析基于瑞典在 2010 年至 2016 年期间招募的 425 例 LADA 新发病例、1417 例 2 型糖尿病新发病例和 1702 名基于人群的对照者。使用问卷调查的方式收集了参与者在诊断/索引年前 5 年中经历的生活事件，包括冲突、离婚、疾病/事故、死亡和经济问题。使用逻辑回归计算比值比（OR）和 95%置信区间（95%CI），并按年龄、性别、BMI、糖尿病家族史、吸烟、身体活动和教育进行调整。
总体而言，经历任何生活事件与 LADA（OR 0.86，95%CI 0.68-1.08）或 2 型糖尿病（OR 1.00，95%CI 0.83-1.21）之间均无关联。对于个别事件和男女分别分析的结果也类似。在谷氨酸脱羧酶抗体更高（中位数）的更具自身免疫性的 LADA（OR（任何生活事件）0.88，95%CI 0.64-1.21）和具有高风险 HLA-DR4-DQ8 基因型的 LADA 携带者中（OR 0.89，95%CI 0.61-1.29）也观察到了类似的结果。
我们的研究结果表明，经历严重的生活事件，包括家庭成员死亡、离婚或经济问题，与 LADA 的总体风险或遗传易感个体的风险增加无关。
