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新生儿筛查 HLA-DQB1 相关 1 型糖尿病风险时的血清 25-羟维生素 D 浓度。

Serum 25-Hydroxyvitamin D Concentrations at Birth in Children Screened for HLA-DQB1 Conferred Risk for Type 1 Diabetes.

机构信息

MediCity, University of Turku, Turku, Finland.

Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland.

出版信息

J Clin Endocrinol Metab. 2019 Jun 1;104(6):2277-2285. doi: 10.1210/jc.2018-02094.

Abstract

CONTEXT

Vitamin D has several effects on the immune system that might be of relevance for the pathogenesis of type 1 diabetes (T1D).

OBJECTIVE

To evaluate whether umbilical cord serum concentrations of 25-hydroxy-vitamin D (25[OH]D) differ in children developing either islet autoimmunity (IA) or overt T1D during childhood and adolescence.

DESIGN

Umbilical cord serum samples from 764 children born from 1994 to 2004 with HLA-DQB1 conferred risk for T1D participating in the Type 1 Diabetes Prediction and Prevention Study were analyzed for 25(OH)D using an enzyme immunoassay.

SETTING

DIPP clinics in Turku, Oulu, and Tampere University Hospitals, Finland.

PARTICIPANTS

Two hundred fifty children who developed T1D diabetes at a median age of 6.7 years (interquartile range [IQR] 4.0 to 10.1 years) and 132 additional case children who developed IA, i.e., positivity for multiple islet autoantibodies. Cases were matched for date of birth, gender, and area of birth with 382 control children who remained autoantibody negative. The median duration of follow up was 9.8 years (IQR 5.7 to 13.1 years).

MAIN OUTCOME MEASURE

The median 25(OH)D concentrations.

RESULTS

The median 25(OH)D concentration in cord serum was low [31.1 nmol/L (IQR 24.0 to 41.8); 88% <50 nmol/L], but not statistically different between children who developed T1D or IA and their control groups (P = 0.70). The levels were associated mainly with geographical location, year and month of birth, age of the mother, and maternal intake of vitamin D during pregnancy.

CONCLUSIONS

The 25(OH)D concentrations at birth are not associated with the development of T1D during childhood.

摘要

背景

维生素 D 对免疫系统有多种影响,这可能与 1 型糖尿病(T1D)的发病机制有关。

目的

评估脐带血清 25-羟维生素 D(25[OH]D)浓度在儿童期和青春期发生胰岛自身免疫(IA)或显性 T1D 的儿童中是否存在差异。

设计

使用酶联免疫吸附试验分析了 1994 年至 2004 年间出生的、具有 T1D 风险 HLA-DQB1 的 764 名儿童的脐带血清样本中的 25(OH)D,这些儿童参加了 1 型糖尿病预测和预防研究。

地点

芬兰图尔库、奥卢和坦佩雷大学医院的 DIPP 诊所。

参与者

250 名儿童在中位数年龄 6.7 岁(四分位间距 [IQR] 4.0 至 10.1 岁)时发展为 T1D 糖尿病,另外 132 名儿童发展为 IA,即多个胰岛自身抗体阳性。病例按出生日期、性别和出生地与 382 名未发生自身抗体的对照儿童相匹配。中位随访时间为 9.8 年(IQR 5.7 至 13.1 年)。

主要观察指标

中位数 25(OH)D 浓度。

结果

脐带血清中 25(OH)D 浓度中位数较低[31.1 nmol/L(IQR 24.0 至 41.8);88% <50 nmol/L],但在发展为 T1D 或 IA 的儿童及其对照组之间无统计学差异(P = 0.70)。水平主要与地理位置、出生年月、母亲年龄和母亲妊娠期间维生素 D 的摄入量有关。

结论

出生时的 25(OH)D 浓度与儿童期 T1D 的发生无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6fb/6489691/fd08033fd25c/jc.2018-02094f1.jpg

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