Oza Chirantap, Karguppikar Madhura, Khadilkar Vaman, Gondhalekar Ketan, Khadilkar Anuradha
Hirabai Cowasji Jehangir Medical Research Institute, Pune, India.
Department of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India; Senior Paediatric Endocrinologist, Jehangir Hospital, Pune and Bombay Hospital, India.
Diabetes Metab Syndr. 2022 Apr;16(4):102453. doi: 10.1016/j.dsx.2022.102453. Epub 2022 Mar 11.
Prevalence of metabolic syndrome (MS) is increasing in children with type-1 diabetes (T1D). Genetic and environmental factors shared among family members are considered significant risk factors. We conducted this study to assess the association of parental MS with development of metabolic risk (MR) in patients with T1D.
This cross-sectional study included 29 patients with T1D along with their parents (29 triads). Demographic data, anthropometry, blood pressure, biochemical measurements and body composition measurements were performed using standard protocols. Insulin resistance was calculated using estimated glucose disposal rate (eGDR) in patients and using HOMA-IR in their parents. MS was diagnosed using International Diabetes Federation Consensus Definition, 2017.
Of total study participants, 44.8% patients with T1D had MR while 25.3% of parents had MS. Low HDL was identified as the most common component of MS. 64.3% patients with T1D, who had parents with MS, had MR. The odds ratio (OR) for development of MR in patients with T1D with parents affected by MS was 4.9 (95% confidence interval 1.0-24.1) while relative risk (RR) was 2.4 (95% confidence interval 0.9-6.1). MR in patients with T1D was found to have a strong correlation with parental MS and also with development of double diabetes (DD).
In conclusion, parental MS increases the risk of development of metabolic abnormalities in patients with T1D. Thus, positive family history may serve as a useful indicator for targeted screening to detect DD.
1型糖尿病（T1D）患儿中代谢综合征（MS）的患病率正在上升。家庭成员共有的遗传和环境因素被认为是重要的危险因素。我们开展这项研究以评估父母患MS与T1D患者代谢风险（MR）发生之间的关联。
这项横断面研究纳入了29例T1D患者及其父母（29个三联家庭）。使用标准方案进行人口统计学数据、人体测量、血压、生化指标测量和身体成分测量。患者的胰岛素抵抗采用估计的葡萄糖处置率（eGDR）计算，其父母则采用稳态模型胰岛素抵抗指数（HOMA-IR）计算。采用2017年国际糖尿病联盟共识定义诊断MS。
在所有研究参与者中，44.8%的T1D患者存在MR，而25.3%的父母患有MS。低高密度脂蛋白被确定为MS最常见的组成部分。父母患有MS的T1D患者中，64.3%存在MR。父母患MS的T1D患者发生MR的优势比（OR）为4.9（95%置信区间1.0 - 24.1），而相对风险（RR）为2.4（95%置信区间0.9 - 6.1）。发现T1D患者的MR与父母患MS以及双糖尿病（DD）的发生均密切相关。
总之，父母患MS会增加T1D患者发生代谢异常的风险。因此，阳性家族史可能是用于检测DD的靶向筛查的有用指标。
