Document Detail


Family history of diabetes and distribution of class II HLA genotypes in children with newly diagnosed type 1 diabetes: effect on diabetic ketoacidosis.
MedLine Citation:
PMID:  21890652     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AbstractObjective: Our purpose was to assess whether family history of diabetes or the HLA DR-DQ genotype of the index case were associated with the frequency of diabetic ketoacidosis (DKA) at diagnosis of childhood type 1 diabetes.Patients and methods: The study cohort comprised 1518 children aged <15 years and diagnosed with type 1 diabetes in Finland in 2002-2005. Family history of type 1 and type 2 diabetes among first-degree relatives (FDR) and grandparents was assessed at diagnosis. HLA DR-DQ genotypes were analyzed using time-resolved fluorometry.Results: In total 12.6% and 1.7% of children had at least one FDR affected with type 1 or type 2 diabetes, respectively, and 6.6% and 34.8% had at least one grandparent with type 1 or type 2 diabetes. DKA (pH<7.30) occurred less frequently in children having a type 1 diabetes affected FDR (7.4% vs. 20.5%, P<0.001). Type 2 diabetes among the parents or grandparents had no such effect. Lower risk HLA genotypes were observed to predispose to DKA (P<0.024). In a logistic regression analysis the risk of DKA was independently associated with the absence of a family member affected by type 1 diabetes, the presence of a low risk HLA genotype and older age at diagnosis (OR 3.23, 1.45 and 1.07, respectively).Conclusion: The presence of type 1 diabetes in a FDR is associated with a decreased risk of DKA at diagnosis. The rate of DKA seems to be higher in children with lower HLA-conferred risk for type 1 diabetes.
Authors:
Anne Hekkala; Ilonen Jorma; Mikael Knip; Riitta Veijola
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-2
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  -     ISSN:  1479-683X     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
A Hekkala, Department of pediatrics, University of Oulu, Oulu, Finland.
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