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儿童和青少年 1 型糖尿病和癫痫:谷氨酸脱羧酶自身抗体是否起作用?来自德国/奥地利/瑞士/卢森堡 DPV 登记处的数据。

Type 1 diabetes and epilepsy in childhood and adolescence: Do glutamic acid decarboxylase autoantibodies play a role? Data from the German/Austrian/Swiss/Luxembourgian DPV Registry.

机构信息

Children's Hospital Dortmund, Dortmund, Germany.

Department of Pediatrics, University of Witten/Herdecke, Witten, Germany.

出版信息

Pediatr Diabetes. 2020 Aug;21(5):766-773. doi: 10.1111/pedi.13034. Epub 2020 May 7.

DOI:10.1111/pedi.13034
PMID:32333480
Abstract

AIMS

We aimed to analyze the relationship between epilepsy and glutamic acid decarboxylase autoantibodies (GADA) in patients with type 1 diabetes mellitus (T1DM) and the impact of GADA on demographic, clinical, and metabolic data in T1DM patients with epilepsy.

METHODS

We searched for patients with T1DM ≤20 years and GADA measurements, and within this group for patients with epilepsy. We formed groups: T1DM + Epilepsy + GADA positive; T1DM + Epilepsy + GADA negative; T1DM + GADA positive; T1DM + GADA negative. We used logistic regression to analyze the relationship between epilepsy and GADA with odds ratio adjusted for sex, duration of diabetes (DOD), and age at diabetes onset (ADO). We used logistic regression with odds ratio adjusted for DOD and ADO onset using epilepsy as a dependent variable and GADA, HbA1c, ketoacidosis, severe hypoglycemia (SH), sex, celiac disease, and autoimmune thyroiditis as independent variables. We conducted regression analyses adjusted for sex, DOD, and ADO to analyze differences in clinical/metabolic parameters between the groups.

RESULTS

Epilepsy was not more frequent in GADA-positive patients (GPP). Logistic regression including all patients with GADA measurements showed that hypoglycemia with coma (HC) correlated with epilepsy when compared to no SH. We found no differences in clinical and metabolic data between GPP and GADA-negative patients (GNP) with epilepsy. SH occurred more often in GPP with epilepsy in comparison to GPP without epilepsy. GNP with epilepsy had a higher rate of HC than GPP without epilepsy.

CONCLUSION

We found no relationship between epilepsy and GADA. A relationship between T1DM and epilepsy might be explainable by SH.

摘要

目的

我们旨在分析 1 型糖尿病(T1DM)患者中癫痫与谷氨酸脱羧酶自身抗体(GADA)之间的关系,以及 GADA 对伴有癫痫的 T1DM 患者的人口统计学、临床和代谢数据的影响。

方法

我们搜索了≤20 岁且有 GADA 检测结果的 T1DM 患者,并在该组患者中搜索了伴有癫痫的患者。我们将患者分为以下几组:T1DM+癫痫+GADA 阳性;T1DM+癫痫+GADA 阴性;T1DM+GADA 阳性;T1DM+GADA 阴性。我们使用逻辑回归分析癫痫与 GADA 之间的关系,并用性别、糖尿病病程(DOD)和糖尿病发病年龄(ADO)校正比值比(OR)。我们使用逻辑回归分析,以癫痫为因变量,用 GADA、糖化血红蛋白(HbA1c)、酮症酸中毒、严重低血糖(SH)、性别、乳糜泻和自身免疫性甲状腺炎为自变量,用 DOD 和 ADO 校正 OR。我们进行了回归分析,校正性别、DOD 和 ADO,以分析各组间临床/代谢参数的差异。

结果

GADA 阳性患者(GPP)中癫痫并不更常见。包括所有有 GADA 检测结果的患者的逻辑回归显示,与无 SH 相比,伴有昏迷的低血糖(HC)与癫痫相关。我们发现伴有癫痫的 GPP 与无癫痫的 GPP 之间在临床和代谢数据上无差异。伴有癫痫的 GPP 中 SH 的发生率高于无癫痫的 GPP。伴有癫痫的 GNP 中 HC 的发生率高于无癫痫的 GPP。

结论

我们未发现癫痫与 GADA 之间存在关系。T1DM 与癫痫之间的关系可能可以用 SH 来解释。

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