Kyvik K O, Nystrom L, Gorus F, Songini M, Oestman J, Castell C, Green A, Guyrus E, Ionescu-Tirgoviste C, McKinney P A, Michalkova D, Ostrauskas R, Raymond N T
The Danish Twin Registry, Epidemiology, Institute of Public Health, University of Southern Denmark, Sdr. Boulevard 23 A, 5000, Odense C, Denmark.
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Diabetologia. 2004 Mar;47(3):377-384. doi: 10.1007/s00125-004-1331-9. Epub 2004 Feb 5.
AIMS/HYPOTHESIS: This prospective study examined the epidemiology of Type 1 diabetes in young adults in Europe.
We ascertained incident cases of Type 1 diabetes in the 15 to 29 years (both inclusive) age group throughout Europe over a period of 2 years. Diabetes registries in nine countries, in which incidence rates for Type 1 diabetes in the 0 to 14 age group were available, took part. Incidence rates were estimated per 100000 person years and standardised for sex and age. Cumulative incidences per 1000 from birth to age 30 were estimated. Heterogeneity between centres was tested with a Poisson regression model.
A total of 2112 diabetes cases were ascertained in 1996 and 1997, of which 61.4% were considered to be Type 1 diabetes. Completeness of ascertainment varied from 70 to 90%. Standardised incidence varied from 4.8 per 100000 person years to 13.4 per 100000 person years. The male-female ratio was estimated to be one or more, and in the 25 to 29 age group 1.5 or more in all countries. Cumulative incidences for males and females indicate that the former exceeds the latter from age 24. In the two centres with highest childhood incidence, this applied already from 14 years of age.
CONCLUSIONS/INTERPRETATION: The incidence of Type 1 diabetes in adults is lower than in children and the range of incidence is also reduced, with a less than threefold variation in adults, against an eightfold variation in children. There is a male excess in incidence, especially in the age group 25 to 29 years.
目的/假设:本前瞻性研究调查了欧洲年轻成年人1型糖尿病的流行病学情况。
我们确定了欧洲范围内2年期间15至29岁(含15岁和29岁)年龄组1型糖尿病的新发病例。九个国家的糖尿病登记处参与了研究,这些国家可提供0至14岁年龄组1型糖尿病的发病率数据。发病率按每10万人年估算,并根据性别和年龄进行标准化。估算了从出生到30岁每1000人的累积发病率。采用泊松回归模型检验各中心之间的异质性。
1996年和1997年共确定了2112例糖尿病病例,其中61.4%被认为是1型糖尿病。确诊的完整性从70%到90%不等。标准化发病率从每10万人年4.8例到13.4例不等。估计男女比例为1或更高,在所有国家的25至29岁年龄组中该比例为1.5或更高。男性和女性的累积发病率表明,从24岁起男性发病率超过女性。在儿童期发病率最高的两个中心,这种情况从14岁起就已出现。
结论/解读:成年人1型糖尿病的发病率低于儿童,且发病率范围也有所缩小,成年人的发病率变化不到三倍,而儿童的发病率变化为八倍。发病率男性高于女性,尤其是在25至29岁年龄组。