ETHNICITY AND PREVALENCE OF SCLERODERMA-LIKE SYNDROME - A STUDY OF ARAB AND JEWISH ISRAELI INSULIN-DEPENDENT DIABETIC CHILDREN

Scleroderma-like syndrome (SLS) may represent the earliest apparent di abetes complication in insulin-dependent diabetic (IDDM) patients. To evaluate the frequency of SLS and its association with other diabetes- related pathology in our diabetic population, we studied 153 (127 Jewi sh and 26 Arab) IDDM patients and 45 healthy age- and gender-matched c ontrols (25 Jewish, 20 Arab). The mean age and diabetes duration of th e patients were 14.09 +/- 5.1 years and 51 +/- 45 months, respectively . While no diabetes-related pathology was found in the controls, SLS w as detected in 47% of all patients (skin, 31.4%; arthropathy, 37.9%; b oth, 22%), and nephropathy, neuropathy, and retinopathy were present i n 10.5%, 5.2%, and 4.6%, respectively. Independent of age, SLS directl y correlated with diabetes duration (p < 0.01) and with the presence o f either nephropathy or neuropathy (p < 0.009 and p < 0.005, respectiv ely). One or more features of systemic diabetic involvement were prese nt in 22% of patients with SLS, compared to only 7.2% in patients with out SLS (p < 0.009). When patients were analyzed according to ethnicit y, the frequency of skin involvement and neuropathy were found to be h igher among Arab patients, particularly males (p < 0.002 and p < 0.005 , respectively), and detection of one was significantly associated wit h the presence of the other (p < 0.001). In conclusion, our results su ggest that SLS is the most common diabetic complication among Jewish a nd Arab IDDM patients, and its presence may reflect an inherited tende ncy to develop other serious diabetic complications. Ethnicity (Arab) by itself, particularly when associated with male gender, seems to acc elerate neurological and dermatological diabetic involvement. (C) 1997 Elsevier Science Inc.