Uloha A I, Lialikau S A
Department of Pediatrics, Grodno State Medical University, Belarus.
Endokrynol Diabetol Chor Przemiany Materii Wieku Rozw. 2003;9(2):73-6.
The morbidity of insulin-dependent diabetes mellitus (IDDM) in children develops not evenly. Epidemiological leaps are periodically registered. This character of dynamics suggests the existence of environmental factors having the influence on the IDDM morbidity. One of these environmental factors is viral infection. We have set ourselves as an object to analyze the relationship between the primary morbidity of IDDM and some infectious diseases in children, to build up the prognostic models for the dynamics of IDDM morbidity and to evaluate their quality. Statistic analysis of the relationship between the primary morbidity of chicken pox, scarlet fever, measles, mumps, viral hepatitis, acute intestinal infectious diseases (AIID), acute upper respiratory infections (AURI) and insulin-dependent diabetes mellitus in children of Grodno region covering the period from 1980 to 2001 years has been performed. It has been established, that morbidity rate of IDDM reliably positively correlated with morbidity of AURJ and AIID (accordingly r=0.62; and p=0.02 and r=0.46; p=0.04) and negatively with the scarlet fever and mumps morbidity (accordingly r=-0.55; p=0.008 and r=-0.53; p=0.01). But cluster analysis has shown, that really only indices of AURI and AIID morbidity were connected and formed one cluster. Morbidity rate of IDDM in children in the current year is most closely connected with AURI and AIID frequency in the previous year, but frequency of the above-mentioned infections registered in the same year influences less on diabetes morbidity, not mentioning the infections of 2-years standing which practically have no influence. If the increase in AURI morbidity accounts for 10% as compared to the previous year one may prognosticate with high reliability an increase of primary morbidity of IDDM by 7.7% on the average during the same year, and by 8.3% in the following year. For AIID these indices account for 3.5% and 4.4% correspondingly. In the increase of the morbidity rate of AIID the morbidity rate of IDDM reduces.
儿童胰岛素依赖型糖尿病（IDDM）的发病率并非均匀发展。流行病学上的跳跃现象时有记录。这种动态特征表明存在影响IDDM发病率的环境因素。其中一个环境因素是病毒感染。我们将分析IDDM的初发发病率与儿童某些传染病之间的关系、建立IDDM发病率动态的预后模型并评估其质量作为研究对象。对格罗德诺地区1980年至2001年期间儿童水痘、猩红热、麻疹、腮腺炎、病毒性肝炎、急性肠道传染病（AIID）、急性上呼吸道感染（AURI）的初发发病率与胰岛素依赖型糖尿病之间的关系进行了统计分析。结果发现，IDDM的发病率与AURI和AIID的发病率呈可靠的正相关（相应地，r = 0.62；p = 0.02和r = 0.46；p = 0.04），与猩红热和腮腺炎的发病率呈负相关（相应地，r = -0.55；p = 0.008和r = -0.53；p = 0.01）。但聚类分析表明，实际上只有AURI和AIID的发病率指标相互关联并形成一个聚类。当年儿童IDDM的发病率与上一年AURI和AIID 的发病频率联系最为紧密，而同年记录的上述感染对糖尿病发病率的影响较小，更不用说两年前的感染，实际上其并无影响。如果AURI发病率较上一年增加10%，则可以高度可靠地预测同年IDDM的初发发病率平均增加7.7%，次年增加8.3%。对于AIID，这些指标分别为3.5%和4.4%。AIID发病率增加时，IDDM的发病率会降低。
