| Objective: The etiology of type 1 diabetes mellitus(T1DM)is very complex and has not been fully elucidated.Although many studies support that some environmental factors play an important role in the development of T1 DM,the results of some factors are still controversial.This study investigated the demographic characteristics and related influencing factors of T1 DM in children.To explore the related risk factors and possible interactions of T1 DM in children,so as to provide reference basis for targeted prevention and treatment measures in the future.Methods: Using the method of convenient sampling,106 children with T1 DM diagnosed firstly in the pediatric inpatient department of a third-class hospital were included in the case group in Shenyang from January to December 2018.In the same period,according to the principle of 1:1 matching of age,sex and living area,106 healthy children were selected as the control group.The family situation,early developmental factors and children’s daily routine were investigated.The children signed the informed consent form with the consent of the guardian in the case group and in the control group.The data were analyzed by SPSS 24.0,and descriptive analysis was made of composition of the research factors between the case group and the control group;univariate and multivariate Logistic regression analysis were used to analyze the related risk factors of type 1 diabetes in children,and the additive and multiplicative models were used to analyze the interaction of the risk factors selected by multiple factors on type 1 diabetes in children.Finally,the population attributable risk was estimated for the risk factors selected.Results:(1)The basic characteristics of the respondents: A total of 106 children with type 1 diabetes were included in the case group and 106 healthy children in the control group.The age distribution range of children with type 1 diabetes mellitus was1-14 years old,including 24 children aged 1-6 years old(22.6%),63 children aged7-12 years old(59.5%)and 19 children aged 13-14 years old(17.9%).The average age of diagnosis was 8.02±3.49 years old,the average age was 9.13±3.42 years old,and that of the control group was 9.22±2.02 years old.There was no statistical significance in age,gender and living area between the two groups(p>0.05).(2)Family factors and early development factors of the subjects showed that there were differences in family economy,family history of diabetes,father smoking,father’s education level,mother’s obesity,mother’s education level,infection during pregnancy,vitamin D supplement during pregnancy and breastfeeding factors from 0 to 4 months after birth between the case group and the control group(p<0.05).(3)The results of univariate Logistic regression analysis showed that: 1)compared with the children with poor family economy,the family economy was average(OR=0.12,95%CI:0.05-0.30)and good(OR=0.04,95%CI: 0.01-0.13),and compared with the children whose father’s education level was junior high school or below,the father’s education level is high school(OR=0.12,95%CI: 0.05-0.27)and college or above(OR=0.10,95% CI: 0.04-0.21),compared with the children whose mother’s education level is junior high school or below,the mother’s education level is high school(OR=0.23,95%CI: 0.10-0.53)and college or above(OR=0.12,95%CI: 0.05-0.25),breastfeeding from 0 to 4 months after birth(OR=0.55,95%CI: 0.31-0.98)and vitamin D supplement during pregnancy(OR=0.35,95% CI: 0.20-0.61)are protective factors for type 1 diabetes in children.2)Family history of diabetes(OR=2.45,95%CI:1.36-4.40),father smoking(OR=1.19,95%CI: 1.15-3.46),maternal obesity(OR=5.84,95%CI: 3.03-11.23)and pregnancy infection(OR=3.18,95%CI: 1.20-8.42)were risk factors for type 1 diabetes in children.4)The results of multivariate Logistic regression analysis showed that general family economy(OR=0.22,95%CI:0.06-0.73),good family economy(OR=0.06,95%CI: 0.01-0.31)and father’s educational level college or above(OR=0.17,95%CI: 0.05-0.54)were protective factors for type 1 diabetes in children.Family history of diabetes(OR=2.45,95%CI:1.09-5.50),father smoking(OR=2.94,95%CI: 1.34-6.43),maternal obesity(OR=6.93,95%CI: 2.99-16.07)and pregnancy infection(OR=3.67,95%CI: 1.05-12.87)are risk factors for type 1 diabetes in children.5)The results of interaction analysis among the risk factors showed that: maternal obesity and infection during pregnancy(IOR=0.11,95%CI:0.01-0.96)have multiplicative interaction on type 1 diabetes in children,but no additive interaction has been found on type 1 diabetes in children.6)The estimated population attributable risk of risk factors showed that the corrected population attributable risk(PAR%)of family history of diabetes,father smoking,maternal obesity and pregnancy infection were 26.24%,41.71%,43.59% and 11.67%,respectively.Conclusion:(1)Better family economy and fathers’ higher education level are the protective factors of T1 DM in children;(2)Family history of diabetes,smoking of father,maternal obesity and infection during pregnancy are the risk factors for the occurrence of T1 DM in children;(3)Maternal obesity and maternal infection during pregnancy have multiplicative interaction on type 1 diabetes in children,but no additive interaction has been found on type 1 diabetes in children;therefore,the prevention of T1 DM in children should be started during pregnancy. |
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