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El-Degwi BAA, Awad MES, Laimon W, Askar SA, El-Morsi DAW, Ahmed DAM. The potential Association of Bisphenol A exposure and type 1 diabetes mellitus among Dakahlia Governorate's children sample, Egypt. Toxicol Res (Camb) 2024; 13:tfae093. [PMID: 38912005 PMCID: PMC11188686 DOI: 10.1093/toxres/tfae093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/12/2024] [Indexed: 06/25/2024] Open
Abstract
Background Bisphenol A (BPA) is an endocrine disrupter affecting glucose homeostasis. Objectives This study aimed to investigate BPA's relationship with Type 1 Diabetes Mellitus (T1DM) in Dakahlia Governorate's children, in Egypt. Subjects materials and methods The study had two parts: clinical and experimental. Clinical Study was conducted on 200 children, equally divided into control and T1DM groups. They underwent: demographic data, height, weight, body mass index, glycosylated HbA1C, random blood glucose, and urinary BPA measurements. Experimental Study was conducted on 60 adult albino rats. Rats were randomly divided into three equal groups: control group: received 0.5 mL of pure olive oil, group 1: received 20 mg/kg/day BPA, and group 2: received 100 mg/kg/day BPA orally for 6 weeks. Fasting and two hours postprandial glucose levels were measured at the beginning and end of the study. Histopathological examination and imaging study of the pancreas were done. Results In clinical study: HbA1C and random blood glucose levels in diabetic children showed a significant increase compared to control. Children in control group showed controlled HbA1C, while the T1DM group showed 86% with poor diabetic control. There was a significant increase in BPA level in the T1DM group compared to the control. Rats that received BPA showed a marked increase in fasting and two hours postprandial glucose levels, histopathological changes in the pancreas with more changes determined in the high dose group, and a significant decrease in the islets of Langerhans diameters with group 2 more affected. Conclusion So, BPA exposure could be considered a risk factor for T1DM in children.
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Affiliation(s)
- Basma Ahmed Ali El-Degwi
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Mansoura University El Gomhouria Street, Mansoura 35516, Egypt
| | - Mahmoud El-Sayed Awad
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Mansoura University El Gomhouria Street, Mansoura 35516, Egypt
| | - Wafaa Laimon
- Pediatric Endocrinology and Diabetes Unit, Department of Pediatrics, Mansoura Faculty of Medicine, Mansoura University, Mansoura University Children's Hospital, El Gomhouria Sreet, Mansoura 35516, Egypt
| | - Samar A Askar
- Histology Department, Faculty of Medicine, Mansoura University, El Gomhouria Street, Mansoura, Egypt
| | - Doaa Abdel Wahab El-Morsi
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Mansoura University El Gomhouria Street, Mansoura 35516, Egypt
- Medical Education Department, Faculty of Medicine, Delta University for Science and Technology, International Coastal Rd, Al Hafir WA Al Amal, Al Satamoni, Dakahlia Governorate, 7730103, Egypt
| | - Dalia Alsaied Moustafa Ahmed
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Mansoura University El Gomhouria Street, Mansoura 35516, Egypt
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Hormazábal-Aguayo I, Ezzatvar Y, Huerta-Uribe N, Ramírez-Vélez R, Izquierdo M, García-Hermoso A. Incidence of type 1 diabetes mellitus in children and adolescents under 20 years of age across 55 countries from 2000 to 2022: A systematic review with meta-analysis. Diabetes Metab Res Rev 2024; 40:e3749. [PMID: 38037806 DOI: 10.1002/dmrr.3749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 10/03/2023] [Accepted: 11/11/2023] [Indexed: 12/01/2023]
Abstract
AIMS The aim of this study was to determine the global incidence of type 1 diabetes mellitus (T1DM) in children and adolescents under 20 years of age from 2000 to 2022. MATERIALS AND METHODS Two reviewers searched three electronic databases (PubMed, Web of Science, and CINAHL) for studies published between January 2000 and November 2022. Pooled estimates of T1DM incidence with a 95% confidence interval (CI) per 100,000 person-years were calculated by country/region, sex, age, and COVID-19 pandemic period (pre-COVID-19 and pandemic). RESULTS The study included 126 studies from 55 countries and 18 regions. The incidence rate (IR) of T1DM from 2000 to 2022 was 14.07 (95%CI, 12.15-16.29) per 100,000 person-years. Finland and high-income North America had the highest IR, with 56.81 (95%CI, 55.91-57.73) and 28.77 (95%CI, 26.59-31.13) per 100,000 person-years, respectively. The IR was 13.37 (95%CI, 10.60-16.88) per 100,000 person-years in boys and 13.87 (95%CI, 11.51-16.70) per 100,000 person-years in girls. There were statistically significant differences among different age ranges: 0-4 versus 5-9 and 10-14 years old (p < 0.001); 5-9 versus 15-19 (p < 0.001) and 10-14 versus 15-19 years old (p = 0.003). Finally, during the pandemic period (2020-2022), the IR was 24.84 (95%CI, 17.16-35.96) per 100,000 person-years, which was higher but not significant compared with the prepandemic period (2017-2019) of 13.56 (95%CI, 7.49-24.56) per 100,000 person-years (p = 0.090). CONCLUSIONS The IR of T1DM in children and adolescents under 20 years of age is substantial, especially during the pandemic period, although it varies across regions. More reliable data from additional countries are needed to determine the worldwide incidence of T1DM.
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Affiliation(s)
- Ignacio Hormazábal-Aguayo
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Yasmin Ezzatvar
- Department of Nursing, Universitat de València, Valencia, Spain
| | - Nidia Huerta-Uribe
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Mikel Izquierdo
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Antonio García-Hermoso
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), Pamplona, Spain
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Albishi LA, AlAmri E, Mahmoud AA. Relationships among consanguinity, family history, and the onset of type 1 diabetes in children from Saudi Arabia. Prim Care Diabetes 2022; 16:102-106. [PMID: 34556437 DOI: 10.1016/j.pcd.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/15/2021] [Accepted: 09/06/2021] [Indexed: 10/20/2022]
Abstract
AIMS We aimed to demonstrate the relationship between parental consanguinity and positive family histories of type 1 diabetes mellitus (T1DM) and autoimmune disease and the development of T1DM among children in Saudi Arabia. METHODS This was a cross-sectional case-control study. In total, 192 patients and 188 healthy controls were enrolled from the Pediatric Diabetes Clinic at King Salman Military Hospital between January 2000 and December 2010. Detailed patients' data recorded while distributing questionnaires to control samples included various gradations of consanguinity and family histories of T1DM and autoimmune disease. RESULTS Parental consanguinity was not significantly associated with T1DM; however, children of first-cousin parents showed a higher risk of developing T1DM than did children of second-cousin parents. The presence of a family history of T1DM significantly differed between those with and without T1DM (p < 0.05). No association was observed between a family history of autoimmune disorders and the development of T1DM. CONCLUSIONS Parental consanguinity and family history of autoimmunity were not clearly linked to T1DM development in children, indicating that T1DM is a multifactorial disease. A history of affected first-cousin parents increases the risk of T1DM.
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Affiliation(s)
- Laila Ahmed Albishi
- Pediatric Department, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia.
| | - Eman AlAmri
- Nutrition and Food Science, University of Tabuk, Tabuk, Saudi Arabia
| | - Asmaa A Mahmoud
- Pediatric Department, Faculty of Medicine, Menoufia University, Sebin Elkom, Egypt
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Vlad A, Serban V, Green A, Möller S, Vlad M, Timar B, Sima A, ONROCAD Study Group OBOT. Time Trends, Regional Variability and Seasonality Regarding the Incidence of Type 1 Diabetes Mellitus in Romanian Children Aged 0-14 Years, Between 1996 and 2015. J Clin Res Pediatr Endocrinol 2018; 10:92-99. [PMID: 29082895 PMCID: PMC5985393 DOI: 10.4274/jcrpe.5456] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The incidence of type 1 diabetes mellitus in children is highly variable in the world. The aim of our study was to: 1) analyze the evolution of the incidence of childhood type 1 diabetes in Romania between 1996 and 2015, and: 2) to search for differences amongst age groups, gender, geographic regions and month of diagnosis. METHODS Data on all new cases of type 1 diabetes, aged <15 years, obtained from two independent sources, were included in the study. The statistical methods included modeling of the incidence rates, adjusting for age, sex, calendar year, geographic region and seasonality. RESULTS The study group was composed of 5422 children, with overall completeness of ascertainment estimated at 93.7%. The incidence rate (per 100.000 person-years) rose continuously, from 4.7 [95% confidence interval (CI) 3.9-5.7] in 1996 to 11.0 (95% CI 9.9-12.2) in 2015, by a yearly rate of 5.1%, highest in the youngest and lowest in the oldest children. The mean incidence was significantly higher (p<0.0001) in Transylvania (7.9, 95% CI 7.6-8.3) than in Moldavia (6.5, 95% CI 6.2-6.9) and Muntenia (7.0, 95% CI 6.7-7.3), probably due to differences regarding ethnicity and lifestyle. The monthly incidence showed a sinusoidal pattern, peaking in January and being minimum in June. CONCLUSION The incidence of type 1 diabetes mellitus in Romanian children increased continuously during the study period by a rate that, if maintained, would lead to its doubling every 14 years. Important differences were established between geographic regions and seasonality at diagnosis.
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Affiliation(s)
- Adrian Vlad
- Victor Babes University of Medicine and Pharmacy, Department of Diabetes and Metabolic Diseases, Timisoara, Romania
| | - Viorel Serban
- Cristian Serban Medical Center of Evaluation and Rehabilitation for Children and Adolescents, Buzias, Romania
| | - Anders Green
- University of Southern Denmark, Odense University Hospital, Department of Clinical Research, Odense Patient Data Exploratory Network (OPEN), Odense, Denmark
| | - Sören Möller
- University of Southern Denmark, Odense University Hospital, Department of Clinical Research, Odense Patient Data Exploratory Network (OPEN), Odense, Denmark
| | - Mihaela Vlad
- Victor Babes University of Medicine and Pharmacy, Department of Endocrinology, Timisoara, Romania,* Address for Correspondence: Victor Babes University of Medicine and Pharmacy, Department of Biostatistics and Medical Informatics, Timisoara, Romania Phone: +40722872666 E-mail:
| | - Bogdan Timar
- Victor Babes University of Medicine and Pharmacy, Department of Biostatistics and Medical Informatics, Timisoara, Romania
| | - Alexandra Sima
- Victor Babes University of Medicine and Pharmacy, Department of Diabetes and Metabolic Diseases, Timisoara, Romania
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Chen YL, Huang YC, Qiao YC, Ling W, Pan YH, Geng LJ, Xiao JL, Zhang XX, Zhao HL. Climates on incidence of childhood type 1 diabetes mellitus in 72 countries. Sci Rep 2017; 7:12810. [PMID: 28993655 PMCID: PMC5634499 DOI: 10.1038/s41598-017-12954-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 09/12/2017] [Indexed: 12/25/2022] Open
Abstract
We are aimed to systematically assess the worldwide trend in incidence of childhood type 1 diabetes mellitus (CT1DM) from 1965 to 2012 and to discuss whether climate affect incidence of CT1DM. We searched the relevant literatures in detail to judge the effect of different climates on incidence of CT1DM. The climates included Mediterranean, monsoon, oceanic, continental, savanna, and rainforest. According to different climates, we further researched relevant factor such as sunshine durations and latitudes. The overall incidence of CT1DM in 72 countries was 11.43 (95% CI 10.31–12.55) per 100,000 children/yr. The incidence of CT1DM in Oceanic climate [10.56 (8.69–12.42)] is highest compared with other climates; the incidence in 40°–66°34′N/S [14.71 (12.30–17.29)] is higher than other latitude groups; the incidence in sunshine durations with 3–4 hours per day [15.17 (11.14–19.20)] is highest compared with other two groups; the incidence of CT1DM from 2000 to 2012 [19.58 (14.55–24.60)] is higher than other periods; all p < 0.01. Incidence of CT1DM was increasing from 1965 to 2012, but incidence in Oceanic climate is higher than other climates. Furthermore, it is higher in centers with higher latitude and lower sunshine durations. The climates might play a key role in inducing CT1DM.
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Affiliation(s)
- Yin-Ling Chen
- Center of Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, China.,Department of Immunology, Faculty of basic Medicine, Guilin Medical University, Guilin, 541004, China
| | - Yong-Cheng Huang
- Center of Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, China
| | - Yong-Chao Qiao
- Department of Immunology, Xiangya School of Medicine, Central South University, Changsha, Hunan, 410078, China
| | - Wei Ling
- Center of Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, China
| | - Yan-Hong Pan
- Center of Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, China.,Department of Immunology, Faculty of basic Medicine, Guilin Medical University, Guilin, 541004, China
| | - Li-Jun Geng
- Center of Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, China.,Department of Immunology, Faculty of basic Medicine, Guilin Medical University, Guilin, 541004, China
| | - Jian-Long Xiao
- Center of Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, China.,Department of Immunology, Faculty of basic Medicine, Guilin Medical University, Guilin, 541004, China
| | - Xiao-Xi Zhang
- Center of Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, China. .,Department of Immunology, Faculty of basic Medicine, Guilin Medical University, Guilin, 541004, China.
| | - Hai-Lu Zhao
- Center of Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, China. .,Department of Immunology, Xiangya School of Medicine, Central South University, Changsha, Hunan, 410078, China. .,Department of Immunology, Faculty of basic Medicine, Guilin Medical University, Guilin, 541004, China.
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Sipetic S, Maksimovic J, Vlajinac H, Ratkov I, Sajic S, Zdravkovic D, Sipetic T. Rising incidence of type 1 diabetes in Belgrade children aged 0-14 years in the period from 1982 to 2005. J Endocrinol Invest 2013; 36:307-12. [PMID: 23013910 DOI: 10.3275/8619] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Type 1 diabetes (T1DM) is an autoimmune disease in which both genetic and environmental factors play a role in the etiology. AIM The aim of this study was to analyze the incidence of T1DM. METHODS A retrospective technique was used to register all newly diagnosed cases of T1DM in Belgrade (Serbia) children at the age of 0- 14 yr between 1982 and 2005. The incidence was adjusted directly by age using the Segi's world population as the standard. A total of 702 cases was identified from the two sources: patients' records from two pediatric hospitals in Belgrade referent for the disease, and from the population based register. RESULTS The average annual age adjusted incidence rate of T1DM for Belgrade was 10.4/100,000 [95% confidence interval (95% CI)=3.8-15.4]. It was slightly higher in boys than in girls. The age-specific annual incidence rates (per 100,000) for the age groups 0-4, 5-9, and 10-14 were 5.5 (95% CI=4.5-6.7), 11.9 (95% CI=10.5-13.5), and 15.4 (95% CI=13.8-17.1), respectively. Over the 24 yr incidence rates significantly increased by 8.5% for boys and 3.0% for girls. The highest increase of incidence rate was in the 5-9 age group. DISCUSSION The results obtained are in line with data from other studies showing that the incidence of T1DM has been increasing in almost all populations worldwide.
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Affiliation(s)
- S Sipetic
- Faculty of Medicine, Institute of Epidemiology, University of Belgrade, Visegradska 26, 11000 Belgrade, Serbia
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Stipancić G, La Grasta Sabolić L, Pozgaj Sepec M, Radica A, Skrabić V, Severinski S, Kujundzić Tiljak M. Regional differences in incidence and clinical presentation of type 1 diabetes in children aged under 15 years in Croatia. Croat Med J 2012; 53:141-8. [PMID: 22522992 PMCID: PMC3342644 DOI: 10.3325/cmj.2012.53.141] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
AIM To determine regional differences in the incidence, incidence trends, and clinical presentation of type 1 diabetes in children under the age of 15 years in Croatia in a 9-year period (1995-2003). METHODS We included the patients who had been diagnosed with the disease and had started the insulin treatment before they were 15 years old. Regional differences between eastern, central, and southern Croatia were observed. The gross incidence was expressed by the number of newly diagnosed type 1 diabetes patients in 100000 children of the same age and sex per year, ie, for the 0-14 age group, and for the 0-4, 5-9, and 10-14 subgroups. RESULTS The highest incidence was observed in southern Croatia (10.91 per 100000/y) and the lowest in central Croatia (8.64 per 100000/y), and in eastern Croatia the incidence was 8.93 per 100000/y. All three regions showed a growing incidence trend, which was significant only in eastern and southern Croatia. There was 35.9% of patients with diabetic ketoacidosis in eastern Croatia, 41.7% in central Croatia, and 31.28% in southern Croatia. CONCLUSION Croatian regions show differences in the incidence, incidence trends, and disease presentation of type 1 diabetes. A further follow-up is needed to establish whether the regional differences are a consequence of the population dynamics in the observed period or they will continue to exist, pointing to differences in environmental risk factors.
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Affiliation(s)
- Gordana Stipancić
- Gordana Stipancic, Department of Pediatrics, Sestre Milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia
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Samardzic M, Marinkovic J, Kocev N, Curovic N, Terzic N. Increasing incidence of childhood type 1 diabetes in Montenegro from 1997 to 2006. Pediatr Diabetes 2010; 11:412-6. [PMID: 19912552 DOI: 10.1111/j.1399-5448.2009.00617.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To determine and analyze the incidence of type 1 diabetes mellitus (T1DM) in 0- to 14-yr-old children in Montenegro from 1997 to 2006. RESEARCH DESIGN AND METHODS This was a prospective study. Primary case ascertainment came from a diabetes register and secondary independent data source was from prescription data. Age and sex-standardized incidence rates were calculated using direct method, assuming an equal distribution in each age/sex group. The 95% confidence interval (CI) were estimated assuming the Poisson distribution. The independent effects of calendar year, two 5-yr time periods, sex and age groups were estimated with Poisson regression modeling. RESULTS During the 10-yr period, 184 new cases of type 1 diabetes were identified. Case ascertainment was 100% complete using the capture-recapture method. The mean annual standardized incidence rate over the 10-yr period was 13.4/100 000/yr (95% CI: 11.5-15.5). It increased on average by 4.6% per year (95% CI: -0.4 to -9.6%, p = 0.07). The time-period specific incidence rate from year 1997 to 2001 was significantly lower (10.8; 8.5-13.5) compared with the second period from 2002 to 2006 (16.3; 13.3-19.7), (p < 0.0001). The age-specific incidence for the 0-4-yr age group was significantly lower (8.9; 6.3-12.3) than in 5- to 9-yr age group (14.1; 10.8-18.1); and in the 10-14 yr group (17.2; 13.7-21.3) per 100,000 children. CONCLUSIONS The incidence rate in last 5 yr places Montenegro in the group of countries with moderate risk for development of type 1 diabetes in children. The average annual increase in incidence is 4.6%.
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Affiliation(s)
- Mira Samardzic
- University Children's Hospital, Department of Endocrinology and Diabetes, 20000 Podgorica, Montenegro.
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9
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Stipancic G, La Grasta Sabolic L, Malenica M, Radica A, Skrabic V, Tiljak MK. Incidence and trends of childhood Type 1 diabetes in Croatia from 1995 to 2003. Diabetes Res Clin Pract 2008; 80:122-7. [PMID: 18055059 DOI: 10.1016/j.diabres.2007.10.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2007] [Accepted: 10/17/2007] [Indexed: 11/26/2022]
Abstract
AIMS/HYPOTHESIS The aim of this study was to examine incidence and trends of Type 1 diabetes in children aged 0-14 years in Croatia from 1995 to 2003. METHODS The incidence data were obtained from two sources. The incidence was calculated as the number of newly diagnosed Type 1 diabetes patients per 100,000 person-years for the age group 0-14 years, and subgroups 0-4, 5-9, and 10-14 years. Standardized incidence was calculated using the method of direct standardization to the world standard population for the age group 0-14 years. The ascertainment was estimated with capture-recapture method. Trends in the incidence of Type 1 diabetes for period from 1995 to 2003 in Croatia were analyzed using Poisson regression model. RESULTS The standardized incidence of Type 1 diabetes for the whole age group was 8.87 per 100,000 person-years (95% CI: 5.07-12.68), for girls 8.47 (95% CI: 7.54-9.41) and for boys 9.26 (95% CI: 8.30-10.21). During the studied period, the trend in incidence raised significantly for the whole age group (chi(2)=32.6, p<0.001). The average annual increase in incidence was 9% (95% CI: 5.8-12.2). CONCLUSIONS/INTERPRETATION This rate of incidence places Croatia in a group of countries with moderate risk for development of Type 1 diabetes. The average annual increase in incidence of 9% is markedly higher than in most European countries, and probably reflects lifestyle changes upon economic recovery of the country.
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Affiliation(s)
- G Stipancic
- Department of Pediatrics, University Hospital "Sestre milosrdnice", Vinogradska ulica 29, 10000 Zagreb, Croatia.
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Abstract
The debate on whether infection precipitates or prevents autoimmunity remains a contentious one. Recently the suggestion that some unknown microbe can be at the origin of some chronic inflammatory diseases has been countered by accumulating evidence that decreasing infection rates might have an important role to play in the rising prevalence of autoimmune disorders. The 'Hygiene Hypothesis' was initially postulated to explain the inverse correlation between the incidence of infections and the rise of allergic diseases, particularly in the developed world. Latterly, the Hygiene Hypothesis has been extended to also incorporate autoimmune diseases in general. Amongst the various infectious agents, a particular emphasis has been put on the interaction between parasitic worms and humans. Worm parasites have co-evolved with the mammalian immune system for many millions of years and during this time, they have developed extremely effective strategies to modulate and evade host defences and so maintain their evolutionary fitness. It is therefore reasonable to conclude that the human immune system has been shaped by its relationship with parasitic worms and this may be a necessary requirement for maintaining our immunological health. Fully understanding this relationship may lead to novel and effective treatments for a host of deleterious inflammatory reactions.
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Affiliation(s)
- P Zaccone
- Department of Pathology, Tennis Court Road, Cambridge, UK
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Guja C, Guja L, Nutland S, Rance H, Sebastien M, Todd JA, Ionescu-Tirgoviste C. Type 1 diabetes genetic susceptibility encoded by HLA DQB1 genes in Romania. J Cell Mol Med 2004; 8:249-56. [PMID: 15256073 PMCID: PMC6740070 DOI: 10.1111/j.1582-4934.2004.tb00280.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Most cases of type 1 diabetes (T1DM) are due to an immune-mediated destruction of the pancreatic beta cells, a process that is conditioned by multiple genes and environmental factors. The main susceptibility genes are represented by the class II HLA-DRB1 and DQB1 alleles. The aim of our study was to reconfirm the contribution of HLA-DQB1 polymorphisms to T1DM genetic susceptibility for the Romanian population. For this, 219 Romanian T1DM families were genotyped at high resolution for HLA DQB1 using the PCR-SSOP method (Polymerase Chain Reaction - Sequence Specific Oligonucleotide Probes). Allele transmission to diabetics and unaffected siblings was studied using the Transmission Disequilibrium Test (TDT). We found an increased transmission of DQB1*02 (77.94% transmission, p(TDT) = 7.18 x 10(-11)) and DQB1*0302 (80.95% transmission, p(TDT) = 2.25 x 10(-10)) alleles to diabetics, indicating the diabetogenic effect of these alleles. Conversely, DQB1*0301, DQB1*0603, DQB1*0602, DQB1*0601 and DQB1*05 alleles are protective, being significantly less transmitted to diabetics. In conclusion, our results confirmed the strong effect of HLA-DQB1 alleles on diabetes risk in Romania, with some characteristics which can contribute to the low incidence of T1DM in this country.
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Affiliation(s)
- C Guja
- Institute of Diabetes, Nutrition and Metabolic Disease N. Paulescu. 5-7 I. Movila Street, Bucharest 2, Romania.
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