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围产期和产科因素与 1 型糖尿病发病年龄的相关性:一项队列研究。

Association between perinatal and obstetric factors and early age at diagnosis of type 1 diabetes mellitus: a cohort study.

机构信息

Universidade de São Paulo, Faculdade de Medicina de Bauru, Bauru, SP, Brazil.

Internal Medicine Department - Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.

出版信息

J Pediatr Endocrinol Metab. 2024 Jul 24;37(8):673-679. doi: 10.1515/jpem-2024-0235. Print 2024 Aug 27.

Abstract

OBJECTIVES

To evaluate the association between perinatal and obstetric factors as potential triggers for the early onset of T1DM.

METHODS

This was a retrospective cohort study enrolling 409 patients diagnosed with T1DM, in Bauru, São Paulo, Brazil, from 1981 to 2023. Data were retrieved from medical records, regarding sociodemographic parameters as age, sex, ethnicity, and socioeconomic status. Perinatal and obstetric factors as delivery type, gestational age, filiation order, length of exclusive breastfeeding, maternal age, maternal and fetal blood types, and occurrence of maternal gestational diabetes were also analyzed. An adapted survival analysis was employed to gauge the impact of each assessed variable at the age of T1DM diagnosis.

RESULTS

The median age of T1DM diagnosis was 10.3 years with an interquartile range between 6.4 and 15.5 years. Delivery type and filiation order were the only factors statistically significantly associated with an early age at T1DM diagnosis. Patients who were born through cesarean section and who were firstborns showed a 28.6 and 18.0 % lower age at T1DM diagnosis, respectively, compared to those born through vaginal delivery and those that were nonfirstborns.

CONCLUSIONS

Being born by cesarean section and being firstborn showed to be statistically significant factors to determine an early T1DM diagnosis.

摘要

目的

评估围产期和产科因素作为 T1DM 早期发病的潜在诱因的相关性。

方法

这是一项回顾性队列研究,纳入了 1981 年至 2023 年在巴西保利斯塔州包鲁市诊断为 T1DM 的 409 名患者。数据来自病历,包括年龄、性别、种族和社会经济状况等社会人口学参数。还分析了围产期和产科因素,如分娩方式、胎龄、排行顺序、纯母乳喂养时间、产妇年龄、母婴血型以及母亲妊娠期糖尿病的发生情况。采用适应性生存分析来评估每个评估变量在 T1DM 诊断时的年龄的影响。

结果

T1DM 诊断的中位年龄为 10.3 岁,四分位间距为 6.4 至 15.5 岁。分娩方式和排行顺序是与 T1DM 早诊唯一有统计学意义相关的因素。与经阴道分娩和非头胎出生的患者相比,经剖宫产分娩和头胎出生的患者 T1DM 诊断年龄分别低 28.6%和 18.0%。

结论

经剖宫产分娩和头胎出生被证明是确定 T1DM 早期诊断的具有统计学意义的因素。

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