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儿童暴发性 1 型糖尿病:中国多中心研究。

Fulminant Type 1 Diabetes in Children: A Multicenter Study in China.

机构信息

National Key Discipline of Pediatrics, Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.

Department of Microbiology and Immunology, Dartmouth College, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.

出版信息

J Diabetes Res. 2017;2017:6924637. doi: 10.1155/2017/6924637. Epub 2017 Sep 26.

Abstract

BACKGROUND

To investigate the hospital-based incidence of FT1D in Chinese children and compare the clinical feature with classical T1DM.

METHODS

A cross-sectional study with sixteen hospitals involved. We obtained 23 FT1D cases as group 1, acute-onset T1DM as group 2, and typical T1DM as group 3.

RESULTS

The incidence of FT1D was 1.56% in 16 participating hospitals. The mean age at the onset of group 1 was 2.00 (1.08, 6.51) years old, much younger than that of group 2 (6.11 (3.92, 9.50)) and group 3 (6.92 (4.17, 10.03)). In addition, significant differences were found between three groups: mean BMI and flu-like symptoms with fever and abdominal pain. Follow-up comparison of three groups from Beijing Children's Hospital for at least one year showed that there is no significant difference between the three groups in terms of mean HbA1c levels and insulin injection dosages.

CONCLUSION

FT1D onset age is much younger than that of classical T1D patients. The hospital-based incidence of FT1D in Chinese children was 1.56% in all new-onset T1DM. For the diagnosis, making FT1D alone into a subtype within type 1 diabetes may be meaningful. However, for the treatment and prognosis, such classification should not be helpful to the clinic.

摘要

背景

本研究旨在调查中国儿童中以滤泡辅助性 T 细胞(Tfh)1 型糖尿病(FT1D)的医院发病情况,并与经典 1 型糖尿病(T1DM)的临床特征进行比较。

方法

采用横断面研究方法,共纳入 16 家医院。我们获得了 23 例 FT1D 病例作为第 1 组,急性起病的 T1DM 作为第 2 组,以及典型 T1DM 作为第 3 组。

结果

在参与的 16 家医院中,FT1D 的发病率为 1.56%。第 1 组的发病年龄均值为 2.00(1.08,6.51)岁,明显小于第 2 组(6.11(3.92,9.50))和第 3 组(6.92(4.17,10.03))。此外,三组之间在平均 BMI 和流感样症状(发热和腹痛)方面存在显著差异。对来自北京儿童医院的至少 1 年随访的三组进行比较后发现,三组之间在平均 HbA1c 水平和胰岛素注射剂量方面没有显著差异。

结论

FT1D 的发病年龄明显小于经典 T1DM 患者。中国儿童中以滤泡辅助性 T 细胞(Tfh)1 型糖尿病(FT1D)的医院发病比例为新发 T1DM 的 1.56%。从诊断角度来看,将 FT1D 单独作为 1 型糖尿病的一个亚型可能具有意义。然而,从治疗和预后的角度来看,这种分类对临床并无帮助。

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