Fredriksson Marie, Persson Emma, Möllsten Anna, Lind Torbjörn
Department of Clinical Sciences, Pediatrics, Umeå University, Umea, Sweden
Department of Statistics, Umeå University, Umea, Sweden.
BMJ Open Diabetes Res Care. 2025 Jan 21;13(1):e004709. doi: 10.1136/bmjdrc-2024-004709.
This study aimed to investigate if individuals with childhood-onset type 1 diabetes having a parent with the same condition (parental diabetes) had worse metabolic control and an increased risk of death and renal failure compared with those with parents without type 1 diabetes (sporadic diabetes).
We conducted a population-based cohort study using data from the Swedish Childhood Diabetes Register, including cases with onset of type 1 diabetes before the age of 15 and recorded between 1977 and 2010. The cohort was linked to national registers to compare mortality, renal failure, and glycated hemoglobin (HBA1c) levels.
We identified 16 572 incident cases of childhood-onset type 1 diabetes. Of these, 15 701 had data on parental diabetes status, with 1390 (8.9%) having at least one parent with this condition. HbA1c data were available in 9105 individuals at 20-30 years of age, with the parental group showing higher levels compared with the sporadic diabetes group (8.4% (68 mmol/mol) vs 8.2% (66 mmol/mol), p=0.004). The Cox proportional HR for death in parental diabetes was 1.33 (95% CI 1.00 to 1.75), and the competing risk HR for renal failure was 1.27 (95% CI 1.08 to 1.50). Women in the parental diabetes group had a higher risk of early death (HR 1.79, 95% CI 1.17 to 2.72) compared with the sporadic diabetes group.
Individuals with parental diabetes had slightly higher HbA1c and elevated risks of renal failure and death compared with those with sporadic diabetes, especially pronounced in women. Although the exact mechanisms behind these differences are unclear, we suggest that individualized care may benefit individuals with parental type 1 diabetes.
本研究旨在调查与父母无1型糖尿病的儿童期发病1型糖尿病患者（散发性糖尿病）相比，父母患有相同疾病（父母患糖尿病）的儿童期发病1型糖尿病患者是否具有更差的代谢控制以及更高的死亡和肾衰竭风险。
我们利用瑞典儿童糖尿病登记处的数据进行了一项基于人群的队列研究，纳入1977年至2010年间记录的15岁前发病的1型糖尿病病例。该队列与国家登记处相链接，以比较死亡率、肾衰竭和糖化血红蛋白（HBA1c）水平。
我们确定了16572例儿童期发病1型糖尿病的新发病例。其中，15701例有父母糖尿病状况的数据，1390例（8.9%）至少有一位父母患有此病。9105名20至30岁个体有HbA1c数据，父母患糖尿病组的水平高于散发性糖尿病组（8.4%（68 mmol/mol）对8.2%（66 mmol/mol），p = 0.004）。父母患糖尿病组死亡的Cox比例风险比为1.33（95%可信区间1.00至1.75），肾衰竭的竞争风险比为1.27（95%可信区间1.08至1.50）。与散发性糖尿病组相比，父母患糖尿病组的女性早期死亡风险更高（风险比1.79，95%可信区间1.17至2.72）。
与散发性糖尿病患者相比，父母患糖尿病的个体HbA1c略高，肾衰竭和死亡风险升高，在女性中尤为明显。尽管这些差异背后的确切机制尚不清楚，但我们建议个体化护理可能有益于父母患1型糖尿病的个体。
