Onkamo P, Väänänen S, Karvonen M, Tuomilehto J
Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland.
Diabetologia. 1999 Dec;42(12):1395-403. doi: 10.1007/s001250051309.
AIMS/HYPOTHESIS: Several reports on the incidence of Type I (insulin-dependent) diabetes mellitus have suggested that the incidence is increasing. The aim of this study was to find out whether the incidence is increasing globally or restricted to a selected populations only and to estimate the magnitude of the change in incidence.
During 1960 to 1996 37 studies in 27 countries were carried out. To fulfil the inclusion criteria the study periods ranged from 8-32 years. The temporal trend was fitted by linear regression, with the logarithm of the age-standardized incidence as the dependent variable and the calendar year as the independent variable. Then, the regression coefficient (x 100%) is approximately the average relative increase in incidence per year (as percentage).
Results from the pooled data from all 37 populations showed that the overall increase in incidence was 3.0% per year (95% CI 2.6; 3.3, p = 0.0001). The statistically significant increase was found in 24 of 37 populations including all high incidence (> 14.6 per 100000 a year) populations. The relative increase was, however, steeper in the populations with a lower incidence. The correlation between logarithm of the incidence and the increase in incidence was r = -0.56, p = 0.0004.
CONCLUSION/INTERPRETATION: The incidence of Type I diabetes is increasing worldwide both in low and high incidence populations. By the year 2010 the incidence will be 50 per 100000 a year in Finland and also in many other populations it will exceed 30 per 100000 a year.
目的/假设：多项关于I型（胰岛素依赖型）糖尿病发病率的报告表明发病率正在上升。本研究的目的是查明发病率是在全球范围内上升还是仅局限于特定人群，并估计发病率变化的幅度。
在1960年至1996年期间，对27个国家的37项研究进行了分析。为符合纳入标准，研究期为8至32年。通过线性回归拟合时间趋势，以年龄标准化发病率的对数作为因变量，以日历年作为自变量。然后，回归系数（×100%）近似为每年发病率的平均相对增长率（以百分比表示）。
来自所有37个人群的汇总数据结果显示，发病率的总体年增长率为3.0%（95%置信区间2.6；3.3，p = 0.0001）。在37个人群中的24个发现了具有统计学意义的增长，包括所有高发病率（每年>14.6/10万）人群。然而，发病率较低的人群相对增长率更高。发病率对数与发病率增长之间的相关性为r = -0.56，p = 0.0004。
结论/解读：I型糖尿病的发病率在全球范围内，无论高发病率人群还是低发病率人群都在上升。到2010年，芬兰的发病率将达到每年50/10万，许多其他人群的发病率也将超过每年30/10万。
