https://scholars.lib.ntu.edu.tw/handle/123456789/495666
標題: | Birth order and childhood type 1 diabetes risk: A pooled analysis of 31 observational studies | 作者: | Cardwell C.R. Stene L.C. Joner G. Bulsara M.K. Cinek O. Rosenbauer J. Ludvigsson J. Svensson J. Goldacre M.J. Waldhoer T. Jarosz-Chobot P. Gimeno S.G. LEE-MING CHUANG Roberts C.L. Parslow R.C. Wadsworth E.J. Chetwynd A. Brigis G. Urbonaite B. Šipetić S. Schober E. Devoti G. Ionescu-Tirgoviste C. de Beaufort C.E. Stoyanov D. Buschard K. Radon K. Glatthaar C. Patterson C.C. |
公開日期: | 2011 | 卷: | 40 | 期: | 2 | 起(迄)頁: | 363-374 | 來源出版物: | International Journal of Epidemiology | 摘要: | Background: The incidence rates of childhood onset type 1 diabetes are almost universally increasing across the globe but the aetiology of the disease remains largely unknown. We investigated whether birth order is associated with the risk of childhood diabetes by performing a pooled analysis of previous studies. Methods: Relevant studies published before January 2010 were identified from MEDLINE, Web of Science and EMBASE. Authors of studies provided individual patient data or conducted pre-specified analyses. Meta-analysis techniques were used to derive combined odds ratios (ORs), before and after adjustment for confounders, and investigate heterogeneity. Results: Data were available for 6 cohort and 25 case-control studies, including 11 955 cases of type 1 diabetes. Overall, there was no evidence of an association prior to adjustment for confounders. After adjustment for maternal age at birth and other confounders, a reduction in the risk of diabetes in second-or later born children became apparent [fully adjusted OR=0.90 95% confidence interval (CI) 0.83-0.98; P=0.02] but this association varied markedly between studies (I2=67%). An a priori subgroup analysis showed that the association was stronger and more consistent in children <5years of age (n=25 studies, maternal age adjusted OR=0.84 95% CI 0.75, 0.93; I2=23%). Conclusion: Although the association varied between studies, there was some evidence of a lower risk of childhood onset type 1 diabetes with increasing birth order, particularly in children aged <5 years. This finding could reflect increased exposure to infections in early life in later born children. Published by Oxford University Press on behalf of the International Epidemiological Association ? The Author 2010; all rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-79953723753&doi=10.1093%2fije%2fdyq207&partnerID=40&md5=b2b340ce50dc065f0476d2737c3593cb https://scholars.lib.ntu.edu.tw/handle/123456789/495666 |
ISSN: | 0300-5771 | DOI: | 10.1093/ije/dyq207 | SDG/關鍵字: | age class; child health; cohort analysis; diabetes; disease incidence; etiology; health risk; heterogeneity; meta-analysis; observational method; risk assessment; age; article; birth order; childhood disease; disease association; human; insulin dependent diabetes mellitus; maternal age; meta analysis; observational study; priority journal; risk; Birth Order; Case-Control Studies; Child, Preschool; Diabetes Mellitus, Type 1; Female; Humans; Maternal Age; Odds Ratio |
顯示於: | 醫學系 |
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