儿童扁桃体切除对1型糖尿病风险无影响

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Risk of Type 1 Diabetes in Childhood Not Affected by Tonsillectomy, Adenoidectomy
NEW YORK (Reuters Health) Nov 13 - Tonsillectomy and adenoidectomy are not associated with an altered risk of childhood-onset type 1 diabetes, according to findings published in the October issue of Diabetes Care.

Tonsillectomy and adenoidectomy impact the function of the immune system, which could therefore increase a child's risk of type 1 diabetes by influencing the autoimmune destruction of the pancreatic beta-cells, explain Dr. Chris R. Cardwell, of the Queen's University of Belfast, UK, and colleagues.

On the other hand, they point out, the hygiene hypothesis suggests that frequent early exposure to infections may protect against type 1 diabetes, so children who undergo tonsillectomy or adenoidectomy may have a reduced risk of type 1 diabetes because they are likely to have experienced more respiratory and ear infections in early childhood.

In their study, the researchers examined the risk of type 1 diabetes after tonsillectomy and/or adenoidectomy in 25,488 children younger than 15 years who underwent tonsillectomy and/or adenoidectomy from 1990 to 2003. Subjects were linked to a type 1 diabetes register.

There was little evidence of any difference in the incidence of type 1 diabetes in children after tonsillectomy, adenoidectomy, or either procedure. Standardized incidence ratios of observed-to-expected cases were 1.15, 1.14, and 1.07, respectively.

\"Our findings provide little support for the hygiene hypothesis because we found no evidence of a lower risk of type 1 diabetes in a cohort of children who are likely to have increased experience of recurrent respiratory or ear infections,\" Dr. Cardwell's team concludes.

Diabetes Care 2007;30:2564-2565.