University of Malta Medical School, Msida, Malta.
University of Malta Medical School & Mater Dei Hospital, Msida, Malta.
Endocrine. 2022 Jun;77(1):48-56. doi: 10.1007/s12020-022-03057-0.
The prevalence of type 1 diabetes is increasing worldwide, suggesting that unknown environmental factors are becoming increasingly important in its pathogenesis.
The aim of the study was to investigate the possible role of a number of prenatal and perinatal factors in the aetiology of type 1 diabetes.
Mothers of patients diagnosed with type 1 diabetes (cases) and mothers of children born on the same day and of the same sex as type 1 diabetes patients (controls) were interviewed on a number of prenatal and perinatal factors of interest.
Hand washing prior to eating, frequency of bathing and total stress score were found to be positively associated with the development of type 1 diabetes on univariate analyses. Hand-washing prior to eating and frequency of house cleaning were independently associated with an increased risk of type 1 diabetes, whilst getting dirty was associated with a reduced risk in multivariate analyses. There was no association of type 1 diabetes to removing of outdoor shoes indoors or to the age of first attendance to school or pre-school. There were also no significant associations to parental smoking, parental age, birth order, infant feeding, antibiotic use, mode of delivery or birth weight.
Our data suggest that factors that affect the skin or gut microbiome might be more important than infections or factors affecting the microbiome at other sites.
全球 1 型糖尿病的患病率正在上升，这表明未知的环境因素在其发病机制中变得越来越重要。
本研究旨在探讨一些产前和围产期因素在 1 型糖尿病发病机制中的可能作用。
对确诊为 1 型糖尿病的患者的母亲（病例组）和与 1 型糖尿病患者同日出生且性别相同的儿童的母亲（对照组）进行了一些产前和围产期相关因素的访谈。
单因素分析显示，饭前洗手、洗澡频率和总应激评分与 1 型糖尿病的发生呈正相关。饭前洗手和房屋清洁频率与 1 型糖尿病的发病风险增加独立相关，而变脏与发病风险降低相关。1 型糖尿病与室内脱户外鞋、上学或入托年龄、父母吸烟、父母年龄、出生顺序、婴儿喂养、抗生素使用、分娩方式或出生体重均无关联。
我们的数据表明，可能影响皮肤或肠道微生物组的因素比影响其他部位微生物组的感染或因素更为重要。
