Lipman Terri H, Chang Yuefang, Murphy Kathryn M
School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Diabetes Care. 2002 Nov;25(11):1969-75. doi: 10.2337/diacare.25.11.1969.
To determine the epidemiology of type 1 diabetes in children in Philadelphia from 1990 to 1994, and to identify whether an epidemic occurred during that time period.
This is a descriptive epidemiological study using a retrospective population-based registry in Philadelphia, PA, a city with large white, African-American, and Hispanic (Puerto Rican) populations. All hospitals in Philadelphia that admit children were identified. All charts meeting the following criteria were reviewed: 1) newly diagnosed type 1 diabetes, 2) children 0-14 years of age, 3) children residing in Philadelphia at the time of diagnosis, and 4) those diagnosed from 1 January 1990 to 31 December 1994. Standard type 1 diabetes registry data were abstracted from the charts. Ascertainment of the completeness of the hospital registry was validated by data from the Philadelphia School District. Communicable disease records were reviewed to identify epidemics from 1987 to 1995.
A total of 209 cases were identified, and the combined hospital and school registry was determined to be 96% complete. The overall age-adjusted incidence rate in Philadelphia was 13.3/100,000/year. The highest rate by race continues to be in the Hispanic population (15.5). The incidence in African-American children has increased markedly (12.8), particularly in the 10- to 14-year age-group (22.9). An epidemic of type 1 diabetes occurred from January to June 1993, approximately 2 years after a measles epidemic in Philadelphia.
The overall incidence of type 1 diabetes in Philadelphia is similar to other U.S. registries. The incidence in the Hispanic population continues to be among the highest of any U.S. ethnic group. The marked increase in incidence in the African-American population may be due in part to misclassification of cases actually having type 2 diabetes. The 1993 epidemic may have been due to beta-cell autoimmunity triggered by the measles virus.
确定1990年至1994年费城儿童1型糖尿病的流行病学情况，并确定在此期间是否发生了疫情。
这是一项描述性流行病学研究，使用宾夕法尼亚州费城基于人群的回顾性登记系统，费城有大量白人、非裔美国人和西班牙裔（波多黎各裔）人口。确定了费城所有收治儿童的医院。审查了所有符合以下标准的病历：1）新诊断的1型糖尿病；2）0至14岁的儿童；3）诊断时居住在费城的儿童；4）1990年1月1日至1994年12月31日期间诊断的儿童。从病历中提取标准的1型糖尿病登记数据。通过费城学区的数据验证了医院登记的完整性。审查传染病记录以确定1987年至1995年期间的疫情。
共确定了209例病例，医院和学校联合登记系统的完整性被确定为96%。费城总体年龄调整发病率为每年13.3/10万。按种族划分，发病率最高的仍然是西班牙裔人群（15.5）。非裔美国儿童的发病率显著上升（12.8），特别是在10至14岁年龄组（22.9）。1993年1月至6月发生了1型糖尿病疫情，大约在费城麻疹疫情发生两年后。
费城1型糖尿病的总体发病率与美国其他登记系统相似。西班牙裔人群的发病率仍然是美国所有族裔群体中最高的之一。非裔美国人群发病率的显著上升可能部分归因于对实际患有2型糖尿病病例的错误分类。1993年的疫情可能是由麻疹病毒引发的β细胞自身免疫所致。
