早产儿在未来似乎有更高的糖尿病风险
  • 纳入419万瑞典出生队列数据,平均随访22.5岁,其中有0.7%和0.1%的人患1型和2型糖尿病;
  • 出生孕周和1、2型糖尿病的患病风险呈负相关;
  • 早产儿(<37周)在18岁以前患1、2型糖尿病的风险分别提高1.21、1.26倍;
  • 早产儿在18-43岁内患1、2型糖尿病的风险分别提高1.24、1.49倍;
  • 女性早产儿发生2型糖尿病的风险高于男性早产儿;
  • 兄弟姐妹间分析提示,排除了基因和生活环境因素后,早产儿与糖尿病的关联仍存在。
主编推荐语
小笋干儿
该全国性数据库数据分析提示,早产儿在未来43年内,有更高的患糖尿病的风险。早产儿的长期健康风险近年来备受关注,该研究为此添加了新的证据。
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Diabetologia [IF:7.113]

Preterm birth and risk of type 1 and type 2 diabetes: a national cohort study

早产儿1型和2型糖尿病的风险:全国性队列研究

10.1007/s00125-019-05044-z

2019-12-05, Article

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Abstract:收起
Aims/hypothesis: Preterm birth (gestational age <37 weeks) has been associated with insulin resistance early in life. However, no large population-based studies have examined risks of type 1 and type 2 diabetes and potential sex-specific differences from childhood into adulthood. Clinicians will increasingly encounter adults who were born prematurely and will need to understand their long-term risks. We hypothesised that preterm birth is associated with increased risks of type 1 and type 2 diabetes into adulthood.
Methods: A national cohort study was conducted of all 4,193,069 singletons born in Sweden during 1973–2014, who were followed up for type 1 and type 2 diabetes identified from nationwide diagnoses and pharmacy data to the end of 2015 (maximum age 43 years; median age at the end of follow-up 22.5 years). Cox regression was used to adjust for potential confounders, and co-sibling analyses assessed the influence of shared familial (genetic and/or environmental) factors.
Results: In 92.3 million person-years of follow-up, 27,512 (0.7%) and 5525 (0.1%) people were identified with type 1 and type 2 diabetes, respectively. Gestational age at birth was inversely associated with both type 1 and type 2 diabetes risk. Adjusted HRs for type 1 and type 2 diabetes at age <18 years associated with preterm birth were 1.21 (95% CI, 1.14, 1.28) and 1.26 (95% CI, 1.01, 1.58), respectively, and at age 18–43 years were 1.24 (95% CI, 1.13, 1.37) and 1.49 (95% CI, 1.31, 1.68), respectively, compared with full-term birth. The associations between preterm birth and type 2 (but not type 1) diabetes were stronger among females (e.g. at age 18–43 years, females: adjusted HR, 1.75; 95% CI, 1.47, 2.09; males: 1.28; 95% CI, 1.08, 1.53; p < 0.01 for additive and multiplicative interaction). These associations were only partially explained by shared genetic or environmental factors in families.
Conclusions/interpretation: In this large national cohort, preterm birth was associated with increased risk of type 1 and type 2 diabetes from childhood into early to mid-adulthood. Preterm-born children and adults may need early preventive evaluation and long-term monitoring for diabetes.

First Authors:
Casey Crump

Correspondence Authors:
Casey Crump,Kristina Sundquist

All Authors:
Casey Crump,Jan Sundquist,Kristina Sundquist

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The New York Times

Premature Babies at Higher Diabetes Risk

2019-12-05

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