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Maryam Saeed German Tapia Inger Ariansen Lars C. Stene Ingebjrg Seljeflot Grethe S. Tell Torild Skrivarhaug Geir Joner 《Diabetes care》2021,44(3):810
OBJECTIVETo study whether serum galectin-3 and other biomarkers of inflammation predict coronary heart disease (CHD) in subjects with long-standing childhood-onset type 1 diabetes.RESEARCH DESIGN AND METHODSA population-based nationwide cohort of 299 subjects with type 1 diabetes diagnosed in Norway at <15 years of age during 1973–1982 was examined in 2002–2003 at a mean age of 33 years (range 21–44), with mean diabetes duration of 24 years (range 19–30). Subjects were followed through 31 December 2017 for their first CHD event registered by a hospitalization or cause of death using nationwide registries. Stored serum samples were available for 296 subjects and analyzed for interleukin-6 (IL-6), IL-6 receptor, IL-18, hs-CRP, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1 (TIMP-1), galectin-3, and high-sensitivity troponin T. Adjusted hazard ratios (aHRs) for CHD per SD increase in biomarker were estimated using Cox regression.RESULTSOf 295 subjects, 40 (13.6%) had a documented CHD event during a mean follow-up of 14.4 years (range 0.5–16). IL-6 (aHR 1.32 [95% CI 1.07–1.63]), galectin-3 (aHR 1.44 [95% CI 1.09–1.80]), and TIMP-1 (aHR 1.37 [95% CI 1.04–1.81]) were significant predictors of CHD after adjustment for conventional risk factors.CONCLUSIONSGalectin-3 was significantly associated with future CHD in subjects with type 1 diabetes, and if the results are replicated in larger studies, it may aid in prediction together with conventional risk factors for CHD. 相似文献
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Lena Hanberger Niels Birkebaek Ragnar Bjarnason Ann Kristin Drivvoll Anders Johansen Torild Skrivarhaug Arni V. Thorsson Ulf Samuelsson 《Journal of diabetes science and technology》2014,8(4):738-744
Background:In 2008 a Nordic collaboration was established between the quality registries in Denmark, Iceland, Norway, and Sweden to improve quality of care for children with diabetes. This study aimed to describe those registries and confirm that the registry variables are comparable. Selected variables were used to demonstrate outcome measurements.Methods:The organization of the registries and methodology are described. Cross-sectional data for patients between birth and 14.9 years with type 1 diabetes mellitus in 2009 (n = 6523) from 89 centers were analyzed. Variables were age, gender, and diabetic ketoacidosis at onset, together with age, gender, HbA1c, insulin regimen, and severe hypoglycemia at follow-up in 2009.Results:All 4 registries use a standardized registration at the onset of diabetes and at follow-up, conducted at the local pediatric diabetes centers. Methods for measuring HbA1c varied as did methods of registration for factors such as hypoglycemia. No differences were found between the outcomes of the clinical variables at onset. Significant variations were found at follow-up for mean HbA1c, the proportion of children with HbA1c < 57 mmol/mol (NGSP/DCCT 7.4%), (range 15-31%), the proportion with insulin pumps (range 34-55%), and the numbers with severe hypoglycemia (range 5.6-8.3/100 patient years).Conclusions:In this large unselected population from 4 Nordic countries, a high proportion did not reach their treatment target, indicating a need to improve the quality of pediatric diabetes care. International collaboration is needed to develop and harmonize quality indicators and offers possibilities to study large geographic populations, identify problems, and share knowledge. 相似文献
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Plasma immunological markers in pregnancy and cord blood: A possible link between macrophage chemo‐attractants and risk of childhood type 1 diabetes
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Aims/hypothesis We examined long-term total and cause-specific mortality in a nationwide, population-based Norwegian cohort of patients with
childhood-onset type 1 diabetes.
Materials and methods All Norwegian type 1 diabetic patients who were diagnosed between 1973 and 1982 and were under 15 years of age at diagnosis
were included (n=1,906). Mortality was recorded from diabetes onset until 31 December 2002 and represented 46,147 person-years. The greatest
age attained among deceased subjects was 40 years and the maximum diabetes duration was 30 years. Cause of death was ascertained
by reviews of death certificates, autopsy protocols and medical records. The standardised mortality ratio (SMR) was based
on national background statistics.
Results During follow-up 103 individuals died. The mortality rate was 2.2/1000 person-years. The overall SMR was 4.0 (95% CI 3.2–4.8)
and was similar for males and females. For ischaemic heart disease the SMR was 20.2 (7.3–39.8) for men and 20.6 (1.8–54.1)
for women. Acute metabolic complications of diabetes were the most common cause of death under 30 years of age (32%). Cardiovascular
disease was responsible for the largest proportion of deaths from the age of 30 years onwards (30%). Violent death accounted
for 28% of the deaths in the total cohort (35% among men and 11% among women).
Conclusions/interpretation Childhood-onset type 1 diabetes still carries an increased mortality risk when compared with the general population, particularly
for cardiovascular disease. To reduce these deaths, attention should be directed to the prevention of acute metabolic complications,
the identification of psychiatric vulnerability and the early detection and treatment of cardiovascular disease and associated
risk factors.
Electronic Supplementary Materials Supplementary material is available in the online version of this article at .
T. Skrivarhaug et al.: Mortality of type 1 diabetes in Norway 相似文献
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Bente B. Johansson Henrik U. Irgens Janne Molnes Paweł Sztromwasser Ingvild Aukrust Petur B. Juliusson Oddmund Søvik Shawn Levy Torild Skrivarhaug Geir Joner Anders Molven Stefan Johansson Pål R. Njølstad 《Diabetologia》2017,60(4):625-635
Aims/hypothesis
MODY can be wrongly diagnosed as type 1 diabetes in children. We aimed to find the prevalence of MODY in a nationwide population-based registry of childhood diabetes.Methods
Using next-generation sequencing, we screened the HNF1A, HNF4A, HNF1B, GCK and INS genes in all 469 children (12.1%) negative for both GAD and IA-2 autoantibodies and 469 antibody-positive matched controls selected from the Norwegian Childhood Diabetes Registry (3882 children). Variants were classified using clinical diagnostic criteria for pathogenicity ranging from class 1 (neutral) to class 5 (pathogenic).Results
We identified 58 rare exonic and splice variants in cases and controls. Among antibody-negative patients, 6.5% had genetic variants of classes 3–5 (vs 2.4% in controls; p?=?0.002). For the stricter classification (classes 4 and 5), the corresponding number was 4.1% (vs 0.2% in controls; p?=?1.6?×?10?5). HNF1A showed the strongest enrichment of class 3–5 variants, with 3.9% among antibody-negative patients (vs 0.4% in controls; p?=?0.0002). Antibody-negative carriers of variants in class 3 had a similar phenotype to those carrying variants in classes 4 and 5.Conclusions/interpretation
This is the first study screening for MODY in all antibody-negative children in a nationwide population-based registry. Our results suggest that the prevalence of MODY in antibody-negative childhood diabetes may reach 6.5%. One-third of these MODY cases had not been recognised by clinicians. Since a precise diagnosis is important for treatment and genetic counselling, molecular screening of all antibody-negative children should be considered in routine diagnostics.9.
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