PDF(Pubmed)
Abstract：
Studies examining the association between type 1 diabetes (T1D) and atopic diseases, i.e., atopic dermatitis, allergic rhinitis and asthma have yielded conflicting results due to different algorithms for classification, sample size issues and risk of referral bias of exposed cohorts with frequent contact to health care professionals. Using Danish national registries and well-established disease algorithms, we examined the bidirectional association between T1D and atopic diseases in childhood and adolescence using Cox Proportional Hazard regression compared to two different unexposed cohorts from a population of 1.5 million Danish children born from 1997 to 2018. We found no associations between T1D and atopic dermatitis, allergic rhinitis, or asthma (defined after age five). However, in multivariable analysis we found an increased risk of persistent wheezing (defined as asthma medication before age five) after T1D with an adjusted hazard ratio (aHR) of 1.70 [1.17-2.45]. We also identified an increased risk of developing T1D after persistent wheezing with aHR of 1.24 [1.13-1.36]. This study highlights similar risks of atopic diseases in children with T1D and of T1D in children with atopic disease after age of five years versus healthy controls. However, more research is needed to understand the possible early immunological effects of the link between persistent wheezing and T1D.
摘要：
研究1型糖尿病（T1D）和特应性疾病之间的关联，即，特应性皮炎,由于不同的分类算法，过敏性鼻炎和哮喘产生了相互矛盾的结果，与卫生保健专业人员频繁接触的暴露队列的样本量问题和转诊偏倚风险.使用丹麦国家登记处和完善的疾病算法，我们使用Cox比例风险回归分析,与来自1997年至2018年出生的150万名丹麦儿童的两个不同未暴露队列相比,研究了T1D与儿童期和青春期特应性疾病之间的双向关联.我们没有发现T1D和特应性皮炎之间的关联，过敏性鼻炎,或哮喘（5岁后定义）。然而,在多变量分析中,我们发现T1D后持续性喘息(定义为5岁前哮喘药物治疗)的风险增加,校正风险比(aHR)为1.70[1.17~2.45].我们还发现持续喘息后发生T1D的风险增加，aHR为1.24[1.13-1.36]。这项研究强调了与健康对照组相比，5岁后T1D儿童和T1D儿童的特应性疾病风险相似。然而,需要更多的研究来了解持续性喘息和T1D之间可能的早期免疫效应.
