Immunology Service Germans Trias i Pujol Research Institute and University Hospital, Autonomous University of Barcelona, 08916 Badalona, Spain.
Pediatrics Service Germans Trias i Pujol Research Institute and University Hospital, Autonomous University of Barcelona, 08916 Badalona, Spain.
J Diabetes Res. 2022 Mar 10;2022:6598600. doi: 10.1155/2022/6598600. eCollection 2022.
Betamethasone, a glucocorticoid used to induce lung maturation when there is a risk of preterm delivery, can affect the immune system maturation and type 1 diabetes (T1D) incidence in the progeny. It has been described that prenatal betamethasone protects offspring from experimental T1D development. The main aim of this study was to evaluate the possible association between betamethasone prenatal exposure and T1D in humans. . A retrospective case-control study with a total of 945 children, including 471 patients with T1D and 474 healthy siblings, was performed. Participants were volunteers from the Germans Trias i Pujol Hospital and DiabetesCero Foundation. Parents of children enrolled in the study completed a questionnaire that included questions about weeks of gestation, preterm delivery risk, weight at birth, and prenatal betamethasone exposure of their children. Multiple logistic regression was used to detect the association between betamethasone exposure and T1D.
We compared T1D prevalence between subjects prenatally exposed or unexposed to betamethasone. The percent of children with T1D in the exposed group was 37.5% (21 of 56), and in the unexposed group was 49.52% (410 of 828) ( = 0.139). The percentage of betamethasone-treated subjects with T1D in the preterm group (18.05%, 13 of 72) was significantly higher than that found in the control group (12.5%, 9 of 72) ( = 0.003). The odds ratio for T1D associated with betamethasone in the univariate logistic regression was 0.59 (95% confidence interval, 0.33; 1.03 [ = 0.062]) and in the multivariate logistic regression was 0.83 (95% confidence interval, 0.45; 1.52 [ = 0.389]).
The results demonstrate that the prenatal exposure to betamethasone does not increase T1D susceptibility, and may even be associated with a trend towards decreased risk of developing the disease. These preliminary findings require further prospective studies with clinical data to confirm betamethasone exposure effect on T1D risk.
倍他米松是一种糖皮质激素，用于在早产风险时诱导肺成熟，可影响后代的免疫系统成熟和 1 型糖尿病（T1D）的发病率。已描述了产前倍他米松可保护后代免受实验性 T1D 发展的影响。本研究的主要目的是评估产前倍他米松暴露与人类 T1D 之间的可能关联。
这是一项共纳入 945 名儿童的回顾性病例对照研究，包括 471 名 T1D 患儿和 474 名健康兄弟姐妹。参与者为 Germans Trias i Pujol 医院和 DiabetesCero 基金会的志愿者。入组儿童的父母完成了一份问卷，其中包括关于孕周、早产风险、出生体重和儿童产前倍他米松暴露的问题。多因素逻辑回归用于检测倍他米松暴露与 T1D 之间的关联。
我们比较了接受和未接受倍他米松暴露的 T1D 患儿的患病率。暴露组中 T1D 的患儿比例为 37.5%（56 例中的 21 例），未暴露组为 49.52%（828 例中的 410 例）（=0.139）。早产儿中接受倍他米松治疗的 T1D 患儿比例（18.05%，13/72）明显高于对照组（12.5%，9/72）（=0.003）。单因素逻辑回归中，倍他米松与 T1D 的比值比为 0.59（95%置信区间，0.33；1.03[=0.062]），多因素逻辑回归中，倍他米松与 T1D 的比值比为 0.83（95%置信区间，0.45；1.52[=0.389]）。
结果表明，产前暴露于倍他米松不会增加 T1D 的易感性，甚至可能与降低发病风险的趋势相关。这些初步发现需要进一步的前瞻性研究，以获得临床数据来证实倍他米松暴露对 T1D 风险的影响。
