Schenck Sandra, Rosenbauer Joachim, Niewerth Martina, Klotsche Jens, Minden Kirsten, Schwarz Tobias, Foeldvari Ivan, Horneff Gerd, Weller-Heinemann Frank, Holl Reinhard W, Thon Angelika
German Rheumatism Research Center Berlin, a Leibniz Institute, Berlin, Berlin, Germany.
Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Centre at Heinrich-Heine University Dusseldorf, Dusseldorf, Germany; German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany.
J Pediatr. 2018 Jan;192:196-203. doi: 10.1016/j.jpeds.2017.07.050.
To determine the prevalence of type 1 diabetes mellitus (T1D) in patients with juvenile idiopathic arthritis (JIA) and to characterize patients having both.
Diabetes comorbidity was recorded in the National Pediatric Rheumatologic Database since 2012. Data from the North Rhine-Westphalian diabetes registry served as the reference population for the prevalence of diabetes in the general population. The National Pediatric Rheumatologic Database data were indirectly standardized for age and sex for comparison with the general population. The diabetes prevalence ratio was calculated using the Poisson regression model.
The analysis included 12 269 patients with JIA. A total of 58 patients had comorbid T1D, and the diabetes prevalence was 0.5%. The mean age was 11.6 years at the time of documentation, and the mean disease duration was 4.2 years. Compared with the general population, the prevalence of diabetes in patients with JIA was significantly increased (prevalence ratio 1.76 [95% CI 1.34; 2.28], P < .001). The onset of diabetes in patients with JIA was earlier than that reported in the reference data. Sixty-three percent of patients developed T1D before JIA. On average, diabetes onset was 56 months before the onset of JIA. Patients who first developed JIA developed T1D on average 40 months later. The majority of patients had not received disease-modifying antirheumatic drugs before diabetes onset.
T1D occurs more frequently in patients with JIA than in the general population. The likelihood of T1D occurrence appears to be slightly higher before JIA manifestation and without disease-modifying antirheumatic drug therapy after JIA onset.
确定幼年特发性关节炎（JIA）患者中1型糖尿病（T1D）的患病率，并对同时患有这两种疾病的患者进行特征描述。
自2012年起，在国家儿科风湿病数据库中记录糖尿病合并症情况。北莱茵 - 威斯特法伦州糖尿病登记处的数据作为一般人群糖尿病患病率的参考人群。对国家儿科风湿病数据库的数据按年龄和性别进行间接标准化，以便与一般人群进行比较。使用泊松回归模型计算糖尿病患病率比值。
分析纳入了12269例JIA患者。共有58例患者合并T1D，糖尿病患病率为0.5%。记录时的平均年龄为11.6岁，平均病程为4.2年。与一般人群相比，JIA患者的糖尿病患病率显著升高（患病率比值1.76 [95% CI 1.34; 2.28]，P <.001）。JIA患者糖尿病的发病时间早于参考数据中报告的时间。63%的患者在患JIA之前就患上了T1D。平均而言，糖尿病发病时间比JIA发病时间早56个月。首先患JIA的患者平均在40个月后患上T1D。大多数患者在糖尿病发病前未接受过改善病情的抗风湿药物治疗。
T1D在JIA患者中的发生率高于一般人群。在JIA表现之前T1D发生的可能性似乎略高，且在JIA发病后未接受改善病情的抗风湿药物治疗的情况下也是如此。
