RISK FACTORS AND TREATMENT OF PAEDIATRIC CHRONIC DISEASES

asthma are leading causes of morbidity and mortality worldwide. The worldwide increase in the number of children with chronic diseases is a major conc...
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asthma are leading causes of morbidity and mortality worldwide. The worldwide increase in the number of children with chronic diseases is a major concern. Early detection through improved screening and diagnostic tests, better diagnosis based on updated guidelines, and improved drug therapy have led to more effective treatment of chronic illnesses. Until now not many studies have measured risk factors, complications and treatment of complications in the pediatric population with chronic disease. This thesis, therefore, aimed to explore comorbidities and use of co-medication in children with type 1 diabetes, and in children with asthma. Next to that, we studied risk factors (both genetic and environmental) that were associated with the occurrence of childhood asthma, asthma exacerbations and allergy.

Risk Factors and Treatment of Paediatric Chronic Diseases; Type 1 diabetes, Asthma and Allergy

Chronic diseases such as type 1 diabetes and

RISK FACTORS AND TREATMENT OF PAEDIATRIC CHRONIC DISEASES

Type 1 diabetes, Asthma and Allergy

INVITATION You are cordially invited to the public defense of the PhD dissertation entitled: Risk factors and treatment of pediatric chronic diseases: Type 1 diabetes, asthma and allergy By Fariba Ahmadizar [email protected] 0031645781270 On Monday 24 October 2016 at 14.30 P.M in the “Academiegebouw” of the Utrecht University Address Domplein 29, 3512 JE Utrecht

Fariba Ahmadizar

Followed by the reception at the place

2016

Fariba Ahmadizar

Paranimfen Nilufar Farzan Mariette Nederlof

Risk Factors and Treatment of Paediatric Chronic Diseases Type 1 diabetes, Asthma and Allergy

Risicofactoren en Behandeling van Pediatrische Chronische Ziekten Type 1 diabetes, Astma en Allergie

(met een samenvatting in het Nederlands) Proefschrift ter verkrijging van de graad van doctor aan de Universiteit Utrecht op gezag van de rector magnificus, prof.dr. G.J. van der Zwaan, ingevolge het besluit van het college voor promoties in het openbaar te verdedigen op maandag 24 oktober 2016 des middags te 2.30 uur

Fariba Ahmadizar geboren op 26 maart 1973 te Baneh, Iran

Promotoren: Prof. dr. A. de Boer Prof. dr. A.H. Maitland-van der Zee

This thesis was partly accomplished with financial support from Iranian Ministry Of Health

Printing of this thesis was kindly supported by Stichting KNMP Fondsen, Dutch Heart Foundation, and Stichting Astma Bestrijding and Infection & Immunity

Chapter 5.1

English summary

The worldwide increasing rate in number of children growing up with chronic diseases is a major concern. Chronic diseases are a leading cause of morbidity and mortality worldwide. Although the epidemiology of childhood type 1 diabetes mellitus (T1DM), asthma and allergy is already well documented, very few studies have measured risk factors, complications and treatment thereof in this population.

The aims of the studies in this thesis were to explore: 1) Comorbidities and co-medications use in childhood T1DM including cardiovascular disease (CVD) risk factors, and asthma 2) Risk factors (genetic and environmental) associated with the occurrence of childhood asthma/asthma exacerbations/allergy

In

, the general introduction, an overview was given with respect to the epidemiology

and current knowledge on childhood chronic diseases, related risk factors and complications. T1DM, asthma and allergy are common chronic disorders in children. Susceptibility to these chronic disorders results from interactions between genetic disease susceptibility and environmental factors. T1DM, asthma and allergy are complex diseases, which need continuous medical care as well as multifactorial risk reduction strategies. These children are typically at increased risk of serious health problems and complications that require early treatment.

In

, trends in comorbidities related to T1DM in children, we studied whether children

with T1DM are at increased risk of CVD risk factors (hypertension and hypercholesterolemia) and CVD events compared with age and gender matched children without diabetes mellitus using two different databases; PHARMO in the Netherlands ( ( In

) and CPRD in the UK

). , cardiovascular medication use and cardiovascular disease in children and

adolescents with type 1 diabetes: a population-based cohort study, in a retrospective cohort study between 1999 and 2009 we investigated the 5-years prevalence and incidence rates of CV medication and CVD before and after the onset of diabetes in children aged

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