Aslam Aisha A, Baksh R Asaad, Pape Sarah E, Strydom Andre, Gulliford Martin C, Chan Li F
Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, U.K.
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, U.K.
Diabetes Care. 2022 Sep 30;45(12):2892-9. doi: 10.2337/dc22-0482.
Down syndrome (DS) is the most common form of chromosomal trisomy. Genetic factors in DS may increase the risk for diabetes. This study aimed to determine whether DS is associated with an increased incidence of diabetes and the relationship with obesity across the life span compared with control patients.
This matched population-based cohort study analyzed UK Clinical Practice Research Datalink data from 1990 to 2020.
A total of 9,917 patients with DS and 38,266 control patients were analyzed. Diabetes rates were higher in patients with DS (incidence rate ratio 3.67; 95% CI 2.43-5.55; P < 0.0001) and peaked at a younger age (median age at diagnosis 38 [interquartile range 28-49] years vs. 53 [43-61] years in control patients). Incidence rates (per 1,000 person-years) for type 1 diabetes mellitus were 0.44 (95% CI 0.31-0.61) in patients with DS vs. 0.13 (0.09-0.17) in control patients. Type 2 diabetes mellitus (T2DM) rates were higher in patients with DS versus control patients in age-groups from 5 years up to 34 years. In patients with DS, peak mean BMI was higher and at a younger age (males 31.2 kg/m2 at age 31 years; females 32.1 kg/m2 at 43 years) versus control patients (males 29.5 kg/m2 at 54 years; females 29.2 kg/m2 at 51 years). Obesity was associated with an increased incidence of T2DM.
At younger ages, the incidence of diabetes in patients with DS is up to four times that of control patients. Peak mean BMI is higher and established earlier in DS, contributing to T2DM risk. Further investigation into the relationship between obesity and diabetes in DS is required to inform treatment and prevention measures.
唐氏综合征（DS）是最常见的染色体三体形式。DS中的遗传因素可能会增加患糖尿病的风险。本研究旨在确定DS是否与糖尿病发病率增加相关，以及与对照患者相比，其在整个生命周期中与肥胖的关系。
这项基于人群的匹配队列研究分析了1990年至2020年英国临床实践研究数据链的数据。
共分析了9917例DS患者和38266例对照患者。DS患者的糖尿病发病率更高（发病率比3.67；95%置信区间2.43 - 5.55；P < 0.0001），且在较年轻的年龄达到峰值（诊断时的中位年龄为38岁[四分位间距28 - 49岁]，而对照患者为53岁[43 - 61岁]）。1型糖尿病的发病率（每1000人年）在DS患者中为0.44（95%置信区间0.31 - 0.61），而在对照患者中为0.13（0.09 - 0.17）。在5岁至34岁的年龄组中，DS患者的2型糖尿病（T2DM）发病率高于对照患者。与对照患者相比，DS患者的平均BMI峰值更高且出现得更早（男性在31岁时为31.2kg/m²；女性在43岁时为32.1kg/m²），而对照患者（男性在54岁时为29.5kg/m²；女性在51岁时为29.2kg/m²）。肥胖与T2DM发病率增加相关。
在较年轻的年龄段，DS患者的糖尿病发病率高达对照患者的四倍。DS患者的平均BMI峰值更高且出现得更早，这增加了患T2DM的风险。需要进一步研究DS中肥胖与糖尿病之间的关系，以为治疗和预防措施提供依据。
