Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
Diabetes Care. 2021 May;44(5):1143-1150. doi: 10.2337/dc20-2989. Epub 2021 Apr 6.
To ascertain the association and coaggregation of eating disorders and childhood-onset type 1 diabetes in families.
Using population samples from national registers in Sweden ( = 2,517,277) and Demark ( = 1,825,920), we investigated the within-individual association between type 1 diabetes and eating disorders and their familial coaggregation among full siblings, half siblings, full cousins, and half cousins. On the basis of clinical diagnoses, we classified eating disorders into any eating disorder (AED), anorexia nervosa (AN) and atypical AN, and other eating disorder (OED). Associations were determined with hazard ratios (HRs) with 95% CIs from Cox regressions.
Swedish and Danish individuals with a type 1 diabetes diagnosis had a greater risk of receiving an eating disorder diagnosis (HR [95% CI] Sweden: AED 2.02 [1.80-2.27], AN 1.63 [1.36-1.96], OED 2.34 [2.07-2.63]; Denmark: AED 2.19 [1.84-2.61], AN 1.78 [1.36-2.33], OED 2.65 [2.20-3.21]). We also meta-analyzed the results: AED 2.07 (1.88-2.28), AN 1.68 (1.44-1.95), OED 2.44 (2.17-2.72). There was an increased risk of receiving an eating disorder diagnosis in full siblings in the Swedish cohort (AED 1.25 [1.07-1.46], AN 1.28 [1.04-1.57], OED 1.28 [1.07-1.52]); these results were nonsignificant in the Danish cohort.
Patients with type 1 diabetes are at a higher risk of subsequent eating disorders; however, there is conflicting support for the relationship between having a sibling with type 1 diabetes and an eating disorder diagnosis. Diabetes health care teams should be vigilant about disordered eating behaviors in children and adolescents with type 1 diabetes.
确定进食障碍与儿童期起病 1 型糖尿病在家族中的关联和共聚集性。
我们利用瑞典（=2517277 人）和丹麦（=1825920 人）全国登记处的人群样本，调查了个体内部 1 型糖尿病与进食障碍之间的关联，以及同胞兄弟姐妹、半同胞兄弟姐妹、全表兄弟姐妹和半表兄弟姐妹之间的家族共聚集性。根据临床诊断，我们将进食障碍分为任何进食障碍（AED）、神经性厌食症（AN）和非典型 AN 以及其他进食障碍（OED）。使用 Cox 回归确定风险比（HR）及其 95%置信区间。
瑞典和丹麦被诊断患有 1 型糖尿病的个体发生进食障碍诊断的风险更高（HR [95%CI] 瑞典：AED 2.02 [1.80-2.27]、AN 1.63 [1.36-1.96]、OED 2.34 [2.07-2.63]；丹麦：AED 2.19 [1.84-2.61]、AN 1.78 [1.36-2.33]、OED 2.65 [2.20-3.21]）。我们还对结果进行了荟萃分析：AED 2.07 [1.88-2.28]、AN 1.68 [1.44-1.95]、OED 2.44 [2.17-2.72]。瑞典队列中，同胞兄弟姐妹发生进食障碍诊断的风险增加（AED 1.25 [1.07-1.46]、AN 1.28 [1.04-1.57]、OED 1.28 [1.07-1.52]）；但在丹麦队列中，这些结果没有统计学意义。
1 型糖尿病患者发生后续进食障碍的风险较高；然而，关于患有 1 型糖尿病的同胞兄弟姐妹与进食障碍诊断之间的关系，支持证据存在冲突。1 型糖尿病的医疗保健团队应警惕儿童和青少年中饮食行为障碍。
