目的:是受孕模式(自然,不育症和非试管婴儿,和IVF)与后代中1型糖尿病的风险有关?
结论:后代中1型糖尿病的风险在自然,不育症和非试管婴儿,和IVF概念。
背景:有证据表明,通过IVF出生的儿童代谢功能受损的风险增加。
方法:以人口为基础,进行了巢式病例对照研究,包括2004年1月1日至2017年12月31日期间2.228.073名符合亲子三联征的前瞻性队列中的769名患有1型糖尿病的儿童和3110名非1型糖尿病的儿童.
方法:使用台湾的注册表数据,概念模式分为三类:自然概念,不孕不育,和非IVF(表明不孕症诊断,但没有IVF促进的概念),和IVF概念。根据国际疾病分类确定1型糖尿病的诊断,第9次或第10次修订,临床修改。每个病例与儿童年龄和性别匹配后随机选择的四个对照进行匹配,住宅乡镇,和1型糖尿病发生的日历日期。
结果:基于1430万人-年的随访(中位数,10年),1型糖尿病的发病率分别为5.33、5.61和4.74/100.000人-年。不育症和非试管婴儿,和试管婴儿的概念,分别。与自然概念相比,未生育和非IVF受孕的1型糖尿病风险没有显着差异(调整后的优势比,1.04[95%CI,0.85-1.27])和IVF概念(调整后的赔率比,1.00[95%CI,0.50-2.03])。此外,根据不育来源(男性/女性/两者)和胚胎类型(新鲜/冷冻),1型糖尿病的风险没有显着差异。
结论:尽管使用了台湾登记册的人口水平数据,包括数量有限的暴露病例。我们发现1型糖尿病的风险与不孕症来源或胚胎类型无关;然而,由于分层后暴露事件的数量有限,因此需要谨慎解释。关于父母糖尿病病史的排除标准仅适用于1997年以后,这可能导致残留的混杂因素。
结论:据报道,通过IVF受孕的父母所生的孩子的代谢特征比自然受孕的孩子差。考虑到目前和以前的研究结果,不良的代谢谱可能不足以在儿童期发展为1型糖尿病。
背景:这项研究得到了新光吴浩苏纪念医院的资助(编号:109GB006-1)。资助者在考虑研究设计或收藏方面没有任何作用,分析,数据解释,撰写报告,或决定将文章提交发表。作者没有竞争利益可披露。
背景:不适用。
OBJECTIVE: Is the mode of conception (natural, subfertility and non-IVF, and IVF) associated with the risk of Type 1 diabetes mellitus among offspring?
CONCLUSIONS: The risk of Type 1 diabetes in offspring does not differ among natural, subfertility and non-IVF, and IVF conceptions.
BACKGROUND: Evidence has shown that children born through IVF have an increased risk of impaired metabolic function.
METHODS: A population-based, nested case-control
study was carried out, including 769 children with and 3110 children without Type 1 diabetes mellitus within the prospective cohort of 2 228 073 eligible parent-child triads between 1 January 2004 and 31 December 2017.
METHODS: Using registry data from Taiwan, the mode of conception was divided into three categories: natural conception, subfertility, and non-IVF (indicating infertility diagnosis but no IVF-facilitated conception), and IVF conception. The diagnosis of Type 1 diabetes mellitus was determined according to the International Classification of Diseases, 9th or 10th Revision, Clinical Modification. Each case was matched to four controls randomly selected after matching for child age and sex, residential township, and calendar date of Type 1 diabetes mellitus occurrence.
RESULTS: Based on 14.3 million person-years of follow-up (median, 10 years), the incidence rates of Type 1 diabetes were 5.33, 5.61, and 4.74 per 100 000 person-years for natural, subfertility and non-IVF, and IVF conceptions, respectively. Compared with natural conception, no significant differences in the risk of Type 1 diabetes were observed for subfertility and non-IVF conception (adjusted odds ratio, 1.04 [95% CI, 0.85-1.27]) and IVF conception (adjusted odds ratio, 1.00 [95% CI, 0.50-2.03]). In addition, there were no significant differences in the risk of Type 1 diabetes according to infertility source (male/female/both) and embryo type (fresh/frozen).
CONCLUSIONS: Although the population-level data from Taiwanese registries was used, a limited number of exposed cases was included. We showed risk of Type 1 diabetes was not associated with infertility source or embryo type; however, caution with interpretation is required owing to the limited number of exposed events after the stratification. The exclusion criterion regarding parents\' history of diabetes mellitus was only applicable after 1997, and this might have caused residual confounding.
CONCLUSIONS: It has been reported that children born to parents who conceived through IVF had worse metabolic profiles than those who conceived naturally. Considering the findings of the present and previous studies, poor metabolic profiles may not be sufficient to develop Type 1 diabetes mellitus during childhood.
BACKGROUND: This
study was supported by grants from Shin Kong Wu Ho-Su Memorial Hospital (No. 109GB006-1). The funders had no role in considering the
study design or in the collection, analysis, interpretation of data, writing of the report, or decision to submit the article for publication. The authors have no competing interests to disclose.
BACKGROUND: N/A.