84 research outputs found

    Gestational age and birth weight and the risk of childhood type 1 diabetes : a population-based cohort and sibling design study

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    Objectives: We investigated the effects of gestational age, birthweight, small for gestational age (SGA) and large for gestational age (LGA) on childhood type 1 diabetes. Methods: We conducted a population-based cohort study of all singleton live births in Sweden between 1973-2009 and a sibling-control study. Perinatal data were extracted from the Swedish Medical Birth Register. Children with type 1 diabetes diagnosis were identified from the Swedish National Patient Register. Log-linear Poisson regression and conditional logistic regression were used for data analysis. Results: The study cohort consisted of 3,624,675 singleton live births (42,411,054 person-years). There were 13,944 type 1 diabetes cases during the study period. The sibling-control study consisted of 11,403 children with type 1 diabetes and 17,920 siblings. Gestational age between 33-36 weeks (RR=1.18; [95%CIs: 1.09, 1.28) and 37-38 weeks (RR=1.12; [95%CIs: 1.07, 1.17]) was associated with type 1 diabetes in the cohort study and remained significant in the sibling-control study. SGA (RR=0.83; [95%CIs: 0.75, 0.93]) and LGA (RR=1.14; [95%CIs: 1.04, 1.24]) were associated with type 1 diabetes in the cohort study. The SGA association remained unchanged in the sibling study while the LGA association disappeared. Very low birthweight was associated with a reduced risk of type 1 diabetes. Conclusions: The findings suggest a small association between gestational age and type 1 diabetes that is not likely due to familial confounding factors. Gestational age and type 1 diabetes may be related to insulin resistance due to early life growth restriction or altered gut microbiota in preterm babies.Science Foundation Ireland, Grant Number 12/RC/2272Stockholm County Council (ALF)Manuscrip

    Identification of adults with symptoms suggestive of obstructive airways disease: Validation of a postal respiratory questionnaire

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    BACKGROUND: Two simples scoring systems for a self-completed postal respiratory questionnaire were developed to identify adults who may have obstructive airways disease. The objective of this study was to validate these scoring systems. METHOD: A two-stage design was used. All adults in two practice populations were sent the questionnaire and a stratified random sample of respondents was selected to undergo full clinical evaluation. Three respiratory physicians reviewed the results of each evaluation. A majority decision was reached as to whether the subject merited a trial of obstructive airways disease medication. This clinical decision was compared with two scoring systems based on the questionnaire in order to determine their positive predictive value, sensitivity and specificity. RESULTS: The PPV (positive predictive value) of the first scoring system was 75.1% (95% CI 68.6–82.3), whilst that of the second system was 82.3% (95% CI 75.9–89.2). The more stringent second system had the greater specificity, 97.1% (95% CI 96.0–98.2) versus 95.3% (95% CI 94.0–96.7), but poorer sensitivity 46.9% (95% CI 33.0–66.8) versus 50.3% (95% CI 35.3–71.6). CONCLUSION: This scoring system based on the number of symptoms/risk factors reported via a postal questionnaire could be used to identify adults who would benefit from a trial of treatment for obstructive airways disease
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